Findings on Managed Care Discussed by Investigators at University of Georgia (Use and Discontinuation Rates of Long-acting Injectable Antipsychotics Between Race/ethnicity In Older Adults Using Medicaid Databases): Managed Care

Insurance Daily News

2025 MAR 04 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Researchers detail new data in Managed Care. According to news originating from Athens, Georgia, by NewsRx correspondents, research stated, “The primary objective of this study was to assess the prescribing patterns of long acting injectable (LAI) antipsychotics in an older adult population. Secondary objectives were to determine if there were differences in treatment discontinuation rates between different LAI agents and race/ethnicity.”

Our news journalists obtained a quote from the research from the University of Georgia, “Merative MarketScan Multi-State Medicaid Databases (2017-2021) were used to identify patients 65 years or older who were prescribed a LAI antipsychotic. Pharmacy claims for LAI antipsychotics were referenced via National Drug Code (NDC) by brand/generic name and dose. International Classification of Diseases, 10th edition (ICD-10) codes were used to identify older adults diagnosed with schizophrenia, schizotypal or schizoaffective disorders. Those with dementia or related disorders were censored. Conditional associations between race/ethnicity and generation of LAI antipsychotics were investigated using logistic regression controlling for age, sex, and health plan. Cox proportional hazard regression was used to compare the distribution of time until treatment discontinuation among older adults across LAI antipsychotics. A total of 526 older adults (59% female) with an average age of 70.4 +/- 5.5 years met inclusion for analysis. The most commonly used LAI antipsychotics included paliperidone palmitate-1 month formulation (similar to 35%), haloperidol decanoate (similar to 24%), and risperidone microspheres (similar to 15%). Overall, approximately 32% received LAI first-generation antipsychotics and 68% received LAI second generation antipsychotics. Blacks (n = 204) received LAI first-generation antipsychotics more often than Whites (n = 283); (OR: 1.74, 95% [1.18, 2.56], p< 0.01). When controlling for age, sex, and race/ethnicity, LAI first-generation antipsychotics showed earlier discontinuation rates compared to LAI second-generation antipsychotics (HR: 2.12, 95% CI [1.45, 3.10], p< 0.001). LAI first-generation antipsychotics showed treatment discontinuation significantly earlier compared to LAI second-generation antipsychotics. Furthermore, Blacks were prescribed LAI first-generation antipsychotics at a higher rate than Whites, which may contribute to poorer health outcomes.”

According to the news editors, the research concluded: “Futures studies are needed to establish a causal relationship.”

This research has been peer-reviewed.

For more information on this research see: Use and Discontinuation Rates of Long-acting Injectable Antipsychotics Between Race/ethnicity In Older Adults Using Medicaid Databases. Journal of the American Geriatrics Society, 2025. Journal of the American Geriatrics Society can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Journal of the American Geriatrics Society - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1532-5415)

The news correspondents report that additional information may be obtained from Joshua Caballero, University of Georgia, College of Pharmacy, Dept Clin & Adm Pharm, Athens, GA 30602, United States. Additional authors for this research include Christopher M. Cassara, Jianing Xu, Xianyan Chen, Daniel B. Hall and Henry N. Young.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/jgs.19386. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.