The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #53589

Peter F. Wang, MD, PhD, Healthcare Informatics, Premier, Inc., 2320 Cascade Point Blvd, Charlotte, NC 28266 and Zhongyun Zhao, PhD, Outcomes Research, Eli Lilly and Company, Lilly Coporate Center, DC 4025, Indianapolis, IN 46825, 317-433-7095, zhao@lilly.com.

Objective: To compare pharmacotherapy patterns and treatment outcomes for olanzapine- versus quetiapine-treated hospitalized patients with schizophrenia. Methods: Hospitalized olanzapine- and quetiapine-treated patients discharged with schizophrenia (ICD9: 295.xx) between 01/1999 and 09/2001 were identified using Premier’s PerspectiveTM database, the largest U.S. hospital drug utilization database. Outcome measures include use of other antipsychotics, mood stabilizers, antidepressants, anxiolytics, and hypnotics; length of stay (LOS); and total treatment costs were analyzed by regressions, controlling diagnoses, illness severity, patient and institution characteristics. Results: Of 9,433 patients (54.8% male, mean age 41.5 years), 6,699 were olanzapine-treated and 2,734 quetiapine-treated. After adjusting for confounding factors, olanzapine-treated patients used fewer psychotropic agents (-0.36, p<0.0001) and were less likely to switch to or augment with other atypical antipsychotics (odds ratio (OR)=0.71, 95% confidence interval (CI)=0.62-0.81). Olanzapine-treated patients were less likely to be treated with typical antipsychotics (OR=0.77, CI=0.70-0.85), mood-stabilizers (OR=0.84, CI=0.77-0.93), anxiolytics (OR=0.67, CI=0.60-0.74), or anti-Parkinsonian agents (OR=0.87, CI=0.79-0.96). There was no between-group difference in antidepressant or hypnotic use. Total costs for olanzapine-treated patients were lower (-$678, p<0.0001) as the result of shorter LOS (-11.4%, p<0.0001). Conclusions: Compared to quetiapine, olanzapine treatment for hospitalized patients with schizophrenia was associated with more favorable pharmacotherapy patterns, shorter LOS, and lower costs.

Learning Objectives:

• At the conclusion of the presentation, participants should be able to recognize the relative cost and effectiveness of olanzapine versus quetiapine in the treatment of inpatients with schizophrenia.

Keywords: Mental Health Care, Economic Analysis

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Eli Lilly
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment