The Economic Impact of a Pharmacy-Based Intervention among Patients with Schizophrenia

Introduction: Poor medication adherence among patients with schizophrenia is associated with a high risk of relapse. Therefore, medication adherence interventions have the potential to improve health outcomes and deliver value to US healthcare payers. Given the high cost of schizophrenia care, a key consideration for health care decision-makers is the assessment of cost-effective strategies among patients treated with antipsychotics. The motivating purpose for this study was to identify, estimate, and compare costs and outcomes between the standard of care and a pharmacy-based intervention designed to improve antipsychotic adherence. Methods: A decision-analytic model was developed to evaluate a simulated cohort of patients randomized to a pharmacy-based intervention or standard of care based upon a published study. The analysis evaluated the relative clinical benefits and associated costs of both cohorts. The base case for this model was driven by adherence rates and relative risk of relapse inputs from the literature. Economic inputs were obtained from PharMetrics medical claims data. Appropriate one- and two-way sensitivity analyses were conducted on key model parameters to test the robustness of the model by varying parameter values. Results: In the base-case scenario, pharmacists improved clinical outcomes by reducing the proportion of patients experiencing relapse in one year compared to the standard of care by 4% (15% vs. 19%). The pharmacy-based intervention also reduced overall schizophrenia-related costs over one year compared to standard of care by $565.08 ($7330.77 vs. $7895.77). In the sensitivity analyses, the most sensitive parameters were oral antipsychotic drug costs and relapse rates. Presentation: 37 minute