Healthcare Resource Utilization 12 Months Following Initiation of Olanzapine/Samidorphan: Real-World Assessment of Patients with Schizophrenia

This study used real-world data to examine changes in healthcare resource utilization (HCRU) among patients with schizophrenia in the 12 months after initiating the combination of olanzapine and samidorphan (OLZ/SAM). This retrospective analysis used administrative claims data (October 18, 2020, to December 31, 2023) from the Komodo Healthcare Map. Adults with schizophrenia and continuous enrollment ≥ 12 months before (baseline) and after (follow-up) initiating OLZ/SAM were eligible. Inpatient (IP) admissions, emergency department (ED) and outpatient (OP) visits, and average numbers of IP days/patient were compared between baseline and follow-up. A subgroup analysis of patients receiving OLZ/SAM treatment for the full 12-month follow-up was conducted. A total of 1287 patients with schizophrenia initiating OLZ/SAM were included. Mean (SD) age was 38.8 (13.0) years; 53% were male. Patients were persistent for a mean (SD) of 196.6 (144.6) days. Overall, 481 (37.4%) patients received continuous OLZ/SAM treatment for the full 12-month follow-up. Proportions of patients with ≥ 1 all-cause, mental health–related, or schizophrenia-related IP admission or ED visit significantly decreased between baseline and follow-up (range – 13.0% to – 27.3%; all P < 0.001). Average numbers of all-cause, mental health–related, and schizophrenia-related inpatient days per patient decreased significantly (range – 5.2 to – 5.5 days; all P < 0.001). Proportions of patients with ≥ 1 OP visit were similar during baseline and follow-up, indicating that patients continued receiving outpatient care. Significant reductions in IP admissions and ED visits were also observed in patients receiving OLZ/SAM treatment for the full 12-month follow-up and were larger than those observed in the full cohort. Among patients with schizophrenia, initiating OLZ/SAM was associated with significant and clinically meaningful reductions in acute HCRU compared with baseline. Larger reductions in acute care HCRU were observed among patients who received continuous OLZ/SAM treatment throughout the 12-month follow-up period. A video abstract summarizing the study methods, results, and clinical implications is available in the online version of this article. Antipsychotic medications, including olanzapine, are used to treat schizophrenia but may have side effects, such as weight gain. These side effects may make people less likely to take their medications as prescribed, increasing the risk of symptoms returning and leading to increased healthcare use. The combination of olanzapine and samidorphan (OLZ/SAM) is an antipsychotic medication that effectively treats schizophrenia or bipolar I disorder but with less weight gain than olanzapine alone. We asked if starting OLZ/SAM treatment was associated with reduced healthcare use in patients with schizophrenia. We compared healthcare use in the 12 months before and the 12 months after patients with schizophrenia started taking OLZ/SAM. We used health insurance claim records to analyze differences in inpatient admissions, emergency department visits, outpatient visits, and numbers of days spent in the hospital. We found that fewer patients had an inpatient admission or emergency department visit during the 12-month period after starting OLZ/SAM compared with the 12 months before starting. Patients also spent fewer days in the hospital. Similar numbers of patients had outpatient visits before and after starting OLZ/SAM, suggesting that they continued to receive normal care. For patients who received continuous treatment with OLZ/SAM for the full 12 months, the reductions in inpatient admissions and emergency department visits were larger than those in the overall study group. These results highlight that OLZ/SAM treatment was associated with reductions in healthcare use for patients with schizophrenia.