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

This real-world data analysis examined healthcare resource utilization (HCRU) among patients with bipolar I disorder (BD-I) in the 12 months before and after initiating a combination of olanzapine and samidorphan (OLZ/SAM). This retrospective analysis used administrative claims data (October 18, 2020–December 31, 2023) from the Komodo Healthcare Map. Eligibility criteria included age ≥ 18 years and continuous enrollment in medical and pharmacy benefits ≥ 12 months before (baseline) and after (follow-up) initiating OLZ/SAM. Comparisons between baseline and follow-up included inpatient (IP) admissions, emergency department (ED) and outpatient (OP) visits, and average number of IP days/patient. A subgroup analysis of patients receiving OLZ/SAM for the full 12-month follow-up period was conducted. Overall, 1004 patients with BD-I who initiated OLZ/SAM were included. Mean (SD) age was 39.0 (12.5) years; 691 (68.8%) were female. Mean (SD) persistence was 173.7 (139.9) days. Overall, 300 (29.9%) patients received continuous OLZ/SAM treatment for the full 12-month follow-up period. Proportions of patients with ≥ 1 all-cause, mental health–related, or BD-I–related IP admission or ED visit between baseline and follow-up were significantly reduced (range − 16.4% to − 42.1%; all P < 0.001), as were mean numbers of IP days/patient (range − 3.9 to − 4.6 days; all P < 0.001). Proportions of patients with ≥ 1 OP visit were similar before and after starting OLZ/SAM, indicating that patients continued receiving OP care. Significant reductions in IP admissions and ED visits were also observed in patients receiving OLZ/SAM treatment for the entire 12-month follow-up period; these reductions were observed to be larger than those observed in the full cohort. Among patients with BD-I, initiating OLZ/SAM was associated with significant and clinically meaningful reductions in acute care HCRU compared with baseline. Larger reductions in acute HCRU were observed among patients with greater treatment persistence. Video abstract available for this article. Medications like olanzapine are used to treat bipolar I disorder (BD-I). However, many patients with BD-I may not take their medication as often as prescribed. This puts patients at risk of their symptoms returning (relapse). The combination of olanzapine and samidorphan (OLZ/SAM) is approved in the USA to treat adults with schizophrenia or BD-I. In this study, we asked whether OLZ/SAM treatment could reduce healthcare use, such as hospital stays or emergency department visits, in patients with BD-I. We studied patients who started taking OLZ/SAM and compared healthcare use in the 12 months before and 12 months after they began OLZ/SAM. Using health insurance claim records, we looked at differences in inpatient admissions, emergency department visits, outpatient visits, and numbers of days spent in the hospital. Fewer patients had an inpatient admission or emergency department visit in the 12 months after starting OLZ/SAM treatment compared with the 12 months before starting, suggesting that fewer relapses occurred. Treatment with OLZ/SAM was also associated with fewer days spent in the hospital. Similar percentages of patients had outpatient visits before and after starting OLZ/SAM, suggesting that they continued to receive routine medical care. Patients who stayed on OLZ/SAM for the full 12 months had reductions in inpatient admissions and emergency department visits that were larger than those in the overall study. These results highlight that OLZ/SAM treatment was associated with reductions in healthcare use for patients with BD-I.