INVEGA SUSTENNA is associated with Lower Hospital Readmission Rates for Schizophrenia Patients based on Real World Evidence Study of Medicare Claims Data

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In invega sustenna, Schizophrenia

By: Sara Riascos  Feb. 15, 2022

Background:

Schizophrenia is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. INVEGA SUSTENNA (paliperidone palmitate) is an extended-release antipsychotic drug given by intramuscular injection. Studies have shown that the use of INVEGA SUSTENNA (paliperidone palmitate) is effective six months longer than other common oral antipsychotics in patients with schizophrenia. Resulting in the delay of relapse such as hospitalization, arrest and incarceration. Other studies have shown that the use of INVEGA SUSTENNA (paliperidone palmitate) is associated with a significantly longer time to relapse and less patients to relapse compared to oral antipsychotics. Dexur’s analysis of Real-World Evidence based on Medicare Claims data showed that the use of INVEGA SUSTENNA (paliperidone palmitate) within 7 days of hospitalization was associated with lower hospital readmission rates for Schizophrenia Patients. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real-World Evidence from Medicare Claims data, for hospitalizations between January 2019 to September 2019. Our methodology criteria was as follows:

Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Schizophrenia codes (Listed in table below)

1. Stratified Selected population into cohorts

   1. Schizophrenia patients who dispensed INVEGA SUSTENNA (paliperidone palmitate) within 7 Days of Hospitalization using Part D drugs claims database

   2. Schizophrenia patients who did not dispense INVEGA SUSTENNA (paliperidone palmitate) within 7 Days of Hospitalization

2. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, INVEGA SUSTENNA (paliperidone palmitate) was associated with lower hospital readmission rates for all Primary ICD Diagnosis Codes examined. For patients whose primary ICD Diagnosis was “Schizoaffective disorder, bipolar type” (F250) and when INVEGA SUSTENNA (paliperidone palmitate) was used within 7 days of hospitalization, the readmission rate was 26.80% compared to the cohort where INVEGA SUSTENNA (paliperidone palmitate) was not used, whose readmission rate was 30.30%. The readmission odds ratio for these cohorts was 0.84. The use of INVEGA SUSTENNA (paliperidone palmitate) was associated with a 16% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with INVEGA SUSTENNA (paliperidone palmitate) is shown below.

Primary ICD Diagnosis Code	Primary ICD Diagnosis Code Description	Total Hospitalizations without INVEGA SUSTENNA	Readmission without INVEGA SUSTENNA	Readmission Rate without INVEGA SUSTENNA	Total Hospitalizations with INVEGA SUSTENNA	Readmission with INVEGA SUSTENNA	Readmission Rate with INVEGA SUSTENNA	Readmission Odds Ratio	Reduction in Readmission with INVEGA SUSTENNA (%)	Confidence Interval (-)	Confidence Intervals (+)
F250	Schizoaffective disorder, bipolar type	42,843

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Schizophrenia at major Hospitals were not prescribed INVEGA SUSTENNA (paliperidone palmitate) within 7 days of discharge.

ICD CODE	Hospital	Hospitalizations with Schizophrenia	% of Hospitalizations without INVEGA SUSTENNA
F250	Holly Hill Hospital, RALEIGH, NC, 27610	257	At Least 96.11%
	Bergen New Bridge Medical Center, PARAMUS, NJ, 07652	226	At Least 95.58%
	North Vista Hospital, NORTH LAS VEGAS, NV, 89030	217	At Least 95.39%

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11.

Conclusions:

According to analysis of Real-World Evidence of Medicare Claims data, for hospitalizations between January 2019 to September 2019, the use of INVEGA SUSTENNA (paliperidone palmitate) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Schizophrenia patients. This analysis shows that a significant number of Patients are not dispensed INVEGA SUSTENNA (paliperidone palmitate) after Schizophrenia hospitalizations at major US Hospitals.