Comparative Economic Outcomes Among Patients with Seizures and Comorbid Intellectual and Developmental Disabilities Initiating Eslicarbazepine Acetate, Brivaracetam, or Lacosamide in the LTC Setting
Abstract number :
2.25
Submission category :
7. Anti-seizure Medications / 7C. Cohort Studies
Year :
2022
Submission ID :
2204772
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:26 AM
Authors :
Darshan Mehta, PhD – Sunovion Pharmaceuticals Inc.; Inyoung Lee, PhD – IQVIA Inc.; Riddhi Doshi, PhD – IQVIA Inc.; Mitchell DeKoven, MHSA – IQVIA Inc.; Brian Wensel, Pharm D – Sunovion Pharmaceuticals Inc.; Andrew Thach, PhD – Sunovion Pharmaceuticals Inc.; Gwilym Williams, PhD – Sunovion Pharmaceuticals Inc.
Rationale: To compare economic outcomes among patients with epilepsy or seizure with comorbid intellectual and developmental disabilities (IDD) initiating eslicarbazepine acetate (ESL), brivaracetam (BRV), or lacosamide (LCM) in the long term care (LTC) setting.
Methods: This retrospective, longitudinal cohort analysis used IQVIA’s LTC pharmacy database linked to prescription (Rx) and professional fee (Dx) claims data from 02/01/2015 to 03/31/2021. Patients were included in the analysis if they met the following criteria: (1) age ≥4 years at index date; (2) ≥1 prescription of ESL or BRV or LCM in the LTC pharmacy data at any time between 02/01/2016 to 03/31/2020; (3) diagnosis of seizure or epilepsy in Dx or Charge Data Master database (CDM) (4) presence of IDD conditions. Mutually exclusive cohorts were identified for each pair-wise comparison of 1) ESL vs BRV or 2) ESL vs LCM in the LTC setting. Demographic and clinical characteristics were reported during the baseline period (12 months pre-index). Using generalized linear models, we compared all-cause and epilepsy-specific total and pharmacy costs among two pair-wise comparisons - cohorts of ESL (n=230) versus BRV (n=216) and ESL (n=174) versus LCM (n=1,244) over the 12 months post-index period.
Results: Patients in ESL cohort were older (mean [years]: 49.8 V. 46.2; p=0.087), had fewer prior AEDs (2.8 V. 3.3; p=0.016) and lower baseline pharmacy and total cost than BRV users. ESL cohort was comparable to the LCM cohort in terms of baseline demographic and clinical characteristics. Patients in the ESL cohort had significantly lower baseline pharmacy and total cost than LCM users. After adjusting for baseline differences, compared to patients in BRV cohort, patients in ESL cohort incurred 16.5% lower all-cause total cost (cost ratio=0.84 [0.73-0.95]), 32.7% lower all-cause pharmacy cost (cost ratio=0.62 [0.59-0.76]), 27.3% lower total epilepsy-specific cost (cost ratio=0.72 [0.63-0.84]) and 37.2% lower total epilepsy-specific pharmacy cost (cost ratio=0.63 [0.55-0.71]). Compared to patients in LCM cohort, patients in ESL cohort incurred 31.7% lower all-cause total cost (cost ratio=0.68 [0.6-0.77]), 30.1% lower all-cause pharmacy cost (cost ratio=0.70 [0.63-0.77]), 21.2% lower total epilepsy-specific total cost (cost ratio=0.78 [0.69-0.89]) and 31.5% lower total epilepsy-specific pharmacy cost (cost ratio=0.69 [0.61-0.77]).
Conclusions: Among patients with epilepsy or seizure with comorbid IDD conditions, initiation of ESL in LTC setting was associated with significantly lower all-cause and epilepsy-specific total and pharmacy costs compared to BRV and LCM.
Funding: Sunovion Pharmaceuticals Inc.
Anti-seizure Medications