Table_1_Healthcare resource use and costs reduction with aripiprazole once-monthly in schizophrenia: AMBITION, a real-world study.docx

ObjectiveThis study aims to compare the hospitalization rate in individuals with schizophrenia who started their treatment with aripiprazole once monthly (AOM400) or atypical oral antipsychotics (OA) in Spain. MethodsThis is an observational and retrospective study based on the electronic medical records from the BIG-PAC database. The study population consisted of individuals diagnosed with schizophrenia who initiated their treatment with AOM400 (AOM cohort) or atypical OA (OA cohort) from 01/01/2017 to 31/12/2019. A 1:1 propensity score matching (PSM) procedure was conducted to match individuals of both cohorts. The number and duration of hospitalizations, persistence to treatment, healthcare resources use, and costs were analyzed after 12 months. ResultsAfter the PSM, 1,017 individuals were included in each cohort [age: 41.4 years (SD: 10.6); males: 54.6%]. During the follow-up period, the AOM cohort had a 40% lower risk of hospitalization than the OA group [HR: 0.60 (95% confidence interval, CI: 0.49–0.74)]. The median time to the first hospitalization was longer in individuals with AOM400 compared to those with OA (197 days compared to 174 days; p < 0.004), whereas hospital admissions were shorter (AOM400: 6 compared to OA: 11 days; p < 0.001). After 12 months, individuals receiving AOM400 were more persistent than those with OA (64.9% compared to 53.7%; p < 0.001). The OA cohort required more healthcare resources, mainly visits to primary care physicians, specialists, and emergency rooms than those receiving AOM400 (p ≤ 0.005 in all comparisons). AOM400 reduced the costs of hospitalizations, and emergency room, specialist and primary care visits by 50.4, 36.7, 16.1, and 10.9%, respectively, in comparison to the treatment with atypical OA. AOM400 led to annual cost savings of €1,717.9 per individual, from the societal perspective. ConclusionAripiprazole once monthly reduces the number and duration of hospitalizations, together with the treatment costs of schizophrenia, as it reduces the use of healthcare resources and productivity losses in these individuals.研究目的 本研究旨在对比西班牙精神分裂症患者分别接受每月一次阿立哌唑（Aripiprazole Once Monthly, AOM400）与非典型口服抗精神病药（Atypical Oral Antipsychotics, OA）初始治疗后的住院率。 研究方法 本研究为一项基于BIG-PAC数据库电子病历的观察性回顾性研究。研究人群纳入2017年1月1日至2019年12月31日期间，初始治疗采用AOM400（AOM队列）或非典型OA（OA队列）的精神分裂症确诊患者。采用1:1倾向得分匹配（Propensity Score Matching, PSM）法对两个队列的患者进行匹配。随后分析12个月随访期内的住院次数与住院时长、治疗持续性、医疗资源使用情况及相关成本。 研究结果 倾向得分匹配后，两个队列各纳入1017例患者[年龄：41.4岁（标准差（Standard Deviation, SD）：10.6）；男性占比：54.6%]。随访期间，AOM队列患者的住院风险较OA队列低40%[风险比（Hazard Ratio, HR）：0.60（95%置信区间（Confidence Interval, CI）：0.49–0.74）]。AOM400组患者首次住院的中位时间较OA组长（197天 vs 174天；p<0.004），而单次住院时长更短（AOM400组：6天 vs OA组：11天；p<0.001）。随访12个月后，AOM400组患者的治疗持续性优于OA组（64.9% vs 53.7%；p<0.001）。OA队列患者的医疗资源使用量更高，主要体现在初级保健医师就诊、专科门诊及急诊室就诊次数多于AOM400组（所有比较项p≤0.005）。与非典型OA治疗相比，AOM400分别使住院、急诊就诊、专科门诊及初级保健就诊的成本降低50.4%、36.7%、16.1%及10.9%。从社会视角来看，AOM400可为每位患者年均节省1717.9欧元的治疗成本。 研究结论 每月一次阿立哌唑治疗可减少精神分裂症患者的住院次数与住院时长，同时降低治疗成本，这源于其减少了此类患者的医疗资源消耗与生产力损失。