{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:06:44Z","timestamp":1779887204925,"version":"3.53.1"},"reference-count":27,"publisher":"The Journal of Health Economics and Outcomes Research","issue":"1","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["jheor.org"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pimavanserin is currently the only atypical antipsychotic (AAP) approved by the US Food and Drug Administration for treating hallucinations and delusions in Parkinson\u2019s disease psychosis (PDP). Benefit and efficacy of pimavanserin have been demonstrated through clinical trials; however, understanding other real-world outcomes is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluated healthcare resource utilization (HCRU) patterns before and after pimavanserin initiation to assess benefit and effectiveness of pimavanserin that may be seen in the real-world setting but not in clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective pre-post analysis using 100% Medicare claims data (Parts A, B, and D), April 1, 2015\u2013December 31, 2021, was conducted. The study included AAP treatment\u2013na\u00efve PDP patients who initiated continuous pimavanserin monotherapy (index date) within 6 months of their incident PDP diagnosis, April 1, 2016\u2013December 31, 2020 (ie, patient identification period). Outcomes measured during the 6 months before and after pimavanserin initiation included all-cause and psychiatric-related HCRU; further categorized as inpatient, emergency room (ER), outpatient, and office visits. Significant differences in the percentage of patients with at least 1 all-cause and at least 1 psychiatric-related HCRU were evaluated using McNemar\u2019s tests at\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 694 patients newly diagnosed with PDP who initiated pimavanserin within 6 months of PDP diagnosis, mean age was 76.9 (\u00b16.8) years, 54.8% were male, and 78.3% had concomitant dementia. The percentage of patients with at least 1 all-cause HCRU was significantly higher during the 6 months pre-index vs post-index, with inpatient (26.1% vs 20.5%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), ER (51.3% vs 35.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), outpatient (83.0% vs 79.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), and office visits (97.4% vs 95.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Similarly, the percentage of patients with at least 1 psychiatric-related HCRU was significantly higher 6 months pre-index vs post-index, with inpatient (7.8% vs 4.9%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), ER (9.7% vs 3.5%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), outpatient (23.6% vs 13.0%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u2009.05), and office visits (68.7% vs 55.8%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Newly diagnosed PDP patients initiating pimavanserin within 6 months demonstrated significant reductions in 6-month post-index all-cause and psychiatric-related HCRU. Further analysis examining the association between time of pimavanserin initiation and the magnitude of benefits are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.36469\/001c.154805","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T16:58:48Z","timestamp":1769187528000},"update-policy":"https:\/\/doi.org\/10.36469\/00001","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Early Treatment with Pimavanserin on Healthcare Resource Utilization Among Newly Diagnosed Patients with Parkinson\u2019s Disease Psychosis: A Pre-Post Medicare Claims Database Analysis"],"prefix":"10.36469","volume":"13","author":[{"given":"Nazia","family":"Rashid","sequence":"first","affiliation":[{"name":"Acadia Pharmaceuticals (United States), San Diego, California","department":["Medical Affairs"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krithika","family":"Rajagopalan","sequence":"additional","affiliation":[{"name":"Anlitiks Inc., Windermere, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daksha","family":"Gopal","sequence":"additional","affiliation":[{"name":"Anlitiks Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lambros","family":"Chrones","sequence":"additional","affiliation":[{"name":"Acadia Pharmaceuticals (United States), San Diego, California","department":["Medical Affairs"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilesh","family":"Doshi","sequence":"additional","affiliation":[{"name":"Acadia Pharmaceuticals (United States), San Diego, California","department":["Medical Affairs"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22273","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref1","article-title":"Nuplazid\u00ae (Pimavanserin) prescribing information","author":"Acadia Pharmaceuticals","year":"2018","journal-title":"Acadia Pharmaceuticals Inc."},{"issue":"5","key":"ref2","doi-asserted-by":"publisher","DOI":"10.3390\/biom12050683","article-title":"The novel pimavanserin derivative ST-2300 with histamine H(3) receptor affinity shows reduced 5-HT(2A) binding, but maintains antidepressant- and anxiolytic-like properties in mice","volume":"12","author":"K. Venkatachalam","year":"2022","journal-title":"Biomolecules"},{"issue":"9916","key":"ref3","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/s0140-6736(13)62106-6","article-title":"Pimavanserin for patients with Parkinson's disease psychosis: a randomised, placebo-controlled phase 3 trial","volume":"383","author":"J. Cummings","year":"2014","journal-title":"Lancet"},{"issue":"2","key":"ref4","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1002\/mds.27602","article-title":"Update on treatments for nonmotor symptoms of Parkinson's disease-an evidence-based medicine review","volume":"34","author":"K. Seppi","year":"2019","journal-title":"Mov Disord"},{"issue":"3","key":"ref5","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s40801-024-00433-2","article-title":"Falls and fractures among nursing home residents treated with pimavanserin versus other atypical antipsychotics: analysis of Medicare beneficiaries with Parkinson's disease psychosis","volume":"11","author":"K. Rajagopalan","year":"2024","journal-title":"Drugs Real World Outcomes"},{"issue":"1","key":"ref6","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1080\/13696998.2022.2152600","article-title":"Health care resource utilization patterns among patients with Parkinson's disease psychosis: analysis of Medicare beneficiaries treated with pimavanserin or other-atypical antipsychotics","volume":"26","author":"K. Rajagopalan","year":"2023","journal-title":"J Med Econ"},{"issue":"7","key":"ref7","doi-asserted-by":"publisher","first-page":"e240038","DOI":"10.57264\/cer-2024-0038","article-title":"Healthcare resource utilization among nursing home residents with Parkinson's disease psychosis: an analysis of Medicare beneficiaries treated with pimavanserin or other-atypical antipsychotics","volume":"13","author":"K. Rajagopalan","year":"2024","journal-title":"J Comp Eff Res"},{"issue":"1","key":"ref8","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1080\/13696998.2025.2487358","article-title":"Healthcare resource utilization patterns among patients with Parkinson's disease psychosis and dementia: analysis of US Medicare beneficiaries treated with pimavanserin versus other-atypical antipsychotics or versus quetiapine","volume":"28","author":"K. Rajagopalan","year":"2025","journal-title":"J Med Econ"},{"issue":"1","key":"ref9","doi-asserted-by":"publisher","first-page":"e230114","DOI":"10.57264\/cer-2023-0114","article-title":"Risk of long-term care admissions among Medicare beneficiaries treated with pimavanserin or quetiapine for Parkinson's disease psychosis in USA: a retrospective administrative claims database analysis","volume":"13","author":"K. Rajagopalan","year":"2024","journal-title":"J Comp Eff Res"},{"issue":"1","key":"ref10","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s40801-021-00284-1","article-title":"Falls and fractures in patients with Parkinson's disease-related psychosis treated with pimavanserin vs atypical antipsychotics: a cohort study","volume":"9","author":"J. B. Layton","year":"2022","journal-title":"Drugs Real World Outcomes"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1038\/s41531-018-0058-0","article-title":"Prevalence of Parkinson's disease across North America","volume":"4","author":"C. Marras","year":"2018","journal-title":"NPJ Parkinsons Dis"},{"issue":"2","key":"ref12","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1177\/08919887231195219","article-title":"Caregiver burden in Parkinson disease: a scoping review of the literature from 2017-2022","volume":"37","author":"W. W. Aamodt","year":"2024","journal-title":"J Geriatr Psychiatry Neurol"},{"issue":"5","key":"ref13","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s40263-024-01084-1","article-title":"On the optimal diagnosis and the evolving role of pimavanserin in Parkinson's disease psychosis","volume":"38","author":"F. L. Pagan","year":"2024","journal-title":"CNS Drugs"},{"key":"ref14","article-title":"Hospital Outpatient Quality Reporting Program","author":"CMS"},{"key":"ref15","article-title":"How to identify hospital claims for emergency room visits in the Medicare claims data","author":"Research Data Assistance Center"},{"key":"ref16","article-title":"What are long-term care hospitals?","author":"Centers for Medicare & Medicaid Services. Department of Health & Human Services"},{"key":"ref17","article-title":"Skilled nursing facility care","author":"Medicare"},{"key":"ref18","article-title":"Pimavanserin treatment timing affects Parkinson disease psychosis resolution","author":"Psychiatric Advisor","year":"2024"},{"issue":"6","key":"ref19","doi-asserted-by":"publisher","first-page":"262","DOI":"10.9740\/mhc.2017.11.262","article-title":"Treatment of psychotic symptoms in patients with Parkinson disease","volume":"7","author":"J. J. Chen","year":"2017","journal-title":"Ment Health Clin"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/s41531-020-0117-1","article-title":"Current and projected future economic burden of Parkinson's disease in the U.S.","volume":"6","author":"W. Yang","year":"2020","journal-title":"NPJ Parkinsons Dis"},{"issue":"1-2","key":"ref21","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jns.2009.08.014","article-title":"Epidemiology of psychosis in Parkinson's disease","volume":"289","author":"G. F\u00e9nelon","year":"2010","journal-title":"J Neurol Sci"},{"issue":"6","key":"ref22","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1002\/mds.23664","article-title":"Parkinson's disease: the quintessential neuropsychiatric disorder","volume":"26","author":"D. Weintraub","year":"2011","journal-title":"Mov Disord"},{"issue":"10 suppl","key":"ref23","first-page":"s199","article-title":"Parkinson's disease psychosis: symptoms, management, and economic burden","volume":"21","author":"N. Hermanowicz","year":"2015","journal-title":"Am J Manag Care"},{"issue":"5 suppl","key":"ref24","first-page":"S83","article-title":"Parkinson's disease and Parkinson's disease psychosis: a perspective on the challenges, treatments, and economic burden","volume":"23","author":"D. Fredericks","year":"2017","journal-title":"Am J Manag Care"},{"issue":"suppl 1","key":"ref25","article-title":"Risk of hospital admission in patients with Parkinson's disease associated psychosis (1991-2010)","volume":"35","author":"C. Stang","year":"2020","journal-title":"Mov Disord"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.parkreldis.2019.10.018","article-title":"Increases in institutionalization, healthcare resource utilization, and mortality risk associated with Parkinson disease psychosis: retrospective cohort study","volume":"68","author":"J. B. Wetmore","year":"2019","journal-title":"Parkinsonism Relat Disord"},{"issue":"4","key":"ref27","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1177\/08919887211018280","article-title":"Psychosis in Parkinson's disease: current treatment options and impact on patients and caregivers","volume":"34","author":"G. S. Segal","year":"2021","journal-title":"J Geriatr Psychiatry Neurol"}],"container-title":["Journal of Health Economics and Outcomes Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jheor.org\/article\/154805-impact-of-early-treatment-with-pimavanserin-on-healthcare-resource-utilization-among-newly-diagnosed-patients-with-parkinson-s-disease-psychosis-a-pr","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:35:40Z","timestamp":1779885340000},"score":1,"resource":{"primary":{"URL":"https:\/\/jheor.org\/article\/154805-impact-of-early-treatment-with-pimavanserin-on-healthcare-resource-utilization-among-newly-diagnosed-patients-with-parkinson-s-disease-psychosis-a-pr"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.36469\/001c.154805","relation":{},"ISSN":["2327-2236"],"issn-type":[{"value":"2327-2236","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]}}}