Real-world data on new users of atypical antipsychotics: characterisation, prescription patterns, healthcare costs and early cardio-metabolic occurrences from a large Italian database

Eur J Clin Pharmacol. 2020 Sep;76(9):1301-1310. doi: 10.1007/s00228-020-02899-9. Epub 2020 May 28.

Abstract

Purpose: To describe new users of atypical antipsychotics (APs) in terms of sociodemographic characteristics, cardio-metabolic risk profile, prescription patterns, healthcare costs and cardio-metabolic events over the 24 months after treatment initiation.

Methods: Atypical AP new users were selected from the ReS database and grouped into three: patients already affected by cardio-metabolic diseases (group A), patients without these clinical conditions but with predisposing conditions (group B) and patients without cardio-metabolic diseases and predisposing conditions (group C). Annual prescription patterns and healthcare costs were analysed. Subjects of groups B and C were matched with controls to compare the occurrences of cardio-metabolic events over 24 months.

Results: Thirty-two thousand thirty-four new users of atypical APs were selected (median age 69). The 22.3% had cardio-metabolic diseases, 14.8% had predisposing conditions and 62.9% had none of these. The 99.3% received monotherapy. The mean annual cost per patient was €2785, and the median cost was €1108. After 24 months, a cardio-metabolic event occurred in 11.5% of group B vs. 8.7% of the controls (p < .01), and in 5.0% of group C vs. 2.1% of the controls (p < .01).

Conclusion: Patients treated with atypical AP were on average old and, in a non-negligible amount, with cardio-metabolic disease or predisposing conditions. New users of atypical APs showed a significantly higher likelihood to develop a cardio-metabolic event early after treatment initiation.

Keywords: Administrative data; Atypical antipsychotic; Cardio-metabolic risk; Italy; Real-world evidence.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Cardiometabolic Risk Factors
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / epidemiology*
  • Databases, Factual
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Italy / epidemiology
  • Male
  • Metabolic Diseases / economics
  • Metabolic Diseases / epidemiology*
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Young Adult

Substances

  • Antipsychotic Agents

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