Abstract：
Schizophrenia is ranked among the top 25 leading causes of disability worldwide in 2013 which resulting in social and economic burden. By observing patients with schizophrenia one year before and after switching from oral antipsychotics (OAPs) to once-monthly paliperidone palmitate (PP1M), we can better understand the change of total costs in schizophrenic patients, including direct costs and indirect costs, after switching treatment patterns.A total of 100 schizophrenic (ICD-10) patients from Shandong Mental Health Center were collected from December 2016 to June 2019. Treatment modalities, health care resource utilization and costs were compared before and after switching directly from oral antipsychotics to PP1M.Of the 82 patients included in the main analyses, treatment with PP1M resulted in an increase in direct costs of 31.92% (P < 0.01), an increase in medicine costs of approximately 142% (P < 0.01), and a reduction in hospital costs of 68.15% (P > 0.05). There was no significant increase in total costs (P = 0.25), while 31.92% increase in direct costs (P < 0.01), and 35.62% decrease in indirect costs (P < 0.01) after conversion to PP1M. Compared with before administration of PP1M, patients with ≥ 1 inpatient stay in 1 year Pre-PP1M treatment with OAPs (n = 32) had a 20.16% decrease in direct costs (P < 0.01), a 144% increase in medicine costs (P < 0.01), and a significant 72.02% decrease in hospital costs (P < 0.01). The observed reduction in the number of hospitalizations (t = 2.56, P ≤ 0.01) and inpatient stays (t = 1.73, P < 0.05) and after transition to PP1M resulted in a reduction in hospitalization costs (P < 0.01).Switching from OAPs to PP1M decreased the household workforce burden without increasing clinical healthcare costs. Direct costs were significantly reduced in patients with ≥ 1 inpatient stay in 1 year pre-PP1M treatment with OAPs after the switch, which decreased by improving adherence to therapy and reducing the number and length of hospital stays, suggesting that those patients may benefit after switching to PP1M.
摘要：
2013年，精神分裂症是导致社会和经济负担的全球25个主要残疾原因之一。通过观察精神分裂症患者从口服抗精神病药（OAP）转换为每月一次的帕潘立酮棕榈酸酯（PP1M）之前和之后一年，我们可以更好地了解精神分裂症患者总费用的变化，包括直接成本和间接成本，切换治疗模式后。收集2016年12月至2019年6月山东省精神卫生中心住院的100例精神分裂症(ICD-10)患者。治疗方式，比较了从口服抗精神病药直接转换为PP1M前后的医疗保健资源利用率和成本.在主要分析的82名患者中，用PP1M治疗导致直接成本增加31.92%(P<0.01)，药品费用增加约142%(P<0.01)，医院费用降低68.15%(P>0.05)。总成本没有显著增加(P=0.25)，而直接成本增加31.92%(P<0.01)，转换为PP1M后，间接成本降低35.62%(P<0.01)。与PP1M给药前相比，在使用OAP的Pre-PP1M治疗中住院时间≥1年的患者（n=32）的直接费用降低了20.16％（P<0.01），药品费用增加144%(P<0.01)，住院费用显著下降72.02%(P<0.01)。观察到的住院次数（t=2.56，P≤0.01）和住院时间（t=1.73，P<0.05）的减少以及过渡到PP1M后的住院费用的减少（P<0.01）。从OAP切换到PP1M减少了家庭劳动力负担，而不增加临床医疗保健成本。转换后，在PP1M治疗前1年内，住院时间≥1的患者的直接费用显着降低，通过提高对治疗的依从性和减少住院次数和住院时间，表明这些患者在改用PP1M后可能会受益。
