Pharmaco-utilisation and related costs of drugs used to treat schizophrenia and bipolar disorder in Italy: the IBIS study

BMC Psychiatry

Flore la Tour⁴  Marianna Alacqua⁴  Carlotta Pasina⁴  Edoardo Spina¹  Claudio Mencacci³  Diego Sangiorgi²  Luca Degli Esposti² 

[1] Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy;Health, Economics, and Outcomes Research, CliCon Srl, Via Salara 36, Ravenna I-48121, Italy;Depression Unit, Neuroscience Department, Fatebenefratelli Hospital, Milan, Italy;AstraZeneca Italy, Basiglio, Italy

关键词: Bipolar disorder;    Schizophrenia;    Pharmaco-utilisation;    Cost of illness;    Real-world practice;    Antipsychotics;   

Others  :  1123310
DOI  :  10.1186/s12888-014-0282-z

 received in 2014-06-04, accepted in 2014-09-30,  发布年份 2014

【 摘 要 】

Background

Schizophrenia and bipolar disorder (BD) are psychiatric diseases that are commonly managed with antipsychotics. Treatment pathways are highly variable and no universal treatment guidelines are available. The primary objective of the Italian Burden of Illness in Schizophrenia and BD (IBIS) study was to describe pharmaco-utilisation of antipsychotic treatments and characteristics of patients affected by schizophrenia or BD. A secondary objective was to describe costs of illness for patients with schizophrenia or BD.

Methods

IBIS was a multicentre, real-world, retrospective, observational cohort study based on data obtained from administrative databases of 16 Local Health Units in Italy (~7.5 million individuals). Patients with schizophrenia or BD ≥18 years of age treated with antipsychotics between 1 January 2008 and 31 December 2009 were included in the primary analysis. Pharmaco-utilisation data were gathered over a follow-up period of 12 months.

Results

Patients with schizophrenia and BD received a wide variety of antipsychotic medications. The proportion of patients on antipsychotic monotherapy was 68% in patients with schizophrenia and 70% in patients with BD. In patients with schizophrenia, ~1/3 of patients receiving antipsychotic monotherapy also received mood stabilisers and/or antidepressants (34.7%) compared with over half of those on antipsychotic polytherapy (52.2%). In patients with BD, use of mood stabilisers and/or antidepressants was even higher; 76.9% of patients receiving antipsychotic monotherapy also received mood stabilisers and/or antidepressants compared with 85.5% of patients on antipsychotic polytherapy. Switch therapy was more frequent in patients with BD than in patients with schizophrenia, whereas add-on therapy was more frequent in patients with schizophrenia than in patients with BD. The mean total disease-related cost per patient per annum was higher in patients with schizophrenia (€4,157) than in patients with BD (€3,301). The number and cost of hospitalisations was higher in patients with BD, whereas the number and cost of nursing home stays was higher in patients with schizophrenia.

Conclusion

Use of administrative databases has permitted retrieval of comprehensive information about therapeutic pathways, diagnostic history and costs in patients affected by schizophrenia or BD. A need for personalised treatment pathways has been described.

Trial registration

clinicaltrials.gov: NCT01392482 webcite; first received June 29, 2011

【 授权许可】

   
2014 Degli Esposti et al.; licensee BioMed Central Ltd.

【 图 表 】

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