Characterization of Economic Burden in Individuals With Narcolepsy or Idiopathic Hypersomnia at Higher Risk of Sodium-Associated Negative Clinical Outcomes in the United States
Author(s)
Caroleen Drachenberg, PhD, MSPH1, Sarah Markt, ScD, MPH1, Lee Surkin, MD2, Richard J Kovacs, MD3, Kaitlyn Easson, PhD4, Silky Beaty, PharmD, MSPH1, Jessica K. Alexander, PhD1, Patrick Gagnon-Sanschagrin, MSc4, Marisa Whalen, PharmD5, Remi Bellefleur, MA4, Mohira Levesque-Leroux, MSc4, Annie Guerin, MSc4, Pam Taub, MD6.
1Jazz Pharmaceuticals, Palo Alto, CA, USA, 2CardioSleep Diagnostics, Greenville, NC, USA, 3Division of Cardiovascular Medicine, Indiana University School of Medicine, Indianapolis, IN, USA, 4Analysis Group, Inc., Montreal, QC, Canada, 5Jazz Pharmaceuticals, Philadelphia, PA, USA, 6Division of Cardiovascular Medicine, University of California San Diego, San Diego, CA, USA.
1Jazz Pharmaceuticals, Palo Alto, CA, USA, 2CardioSleep Diagnostics, Greenville, NC, USA, 3Division of Cardiovascular Medicine, Indiana University School of Medicine, Indianapolis, IN, USA, 4Analysis Group, Inc., Montreal, QC, Canada, 5Jazz Pharmaceuticals, Philadelphia, PA, USA, 6Division of Cardiovascular Medicine, University of California San Diego, San Diego, CA, USA.
Presentation Documents
OBJECTIVES: Quantify healthcare resource utilization (HCRU) and costs for individuals with narcolepsy or idiopathic hypersomnia (IH) at higher-risk of sodium-associated negative clinical outcomes.
METHODS: Continuously-enrolled individuals with narcolepsy or IH were identified from Komodo Research Data (01/01/2016-01/31/2024). Individuals with ≥1 cardiovascular, cardiometabolic, or renal sodium-associated risk factor (defined through literature review/clinical expert discussion) in the 12-month pre-index period (index: first-observed narcolepsy/IH diagnosis) were categorized “higher-risk;” “lower-risk” individuals had no risk factors. Annualized all-cause HCRU and costs (2024 USD) over the ≥12-month post-index period were compared between risk groups using log link generalized linear models with negative binomial and gamma distributions, respectively.
RESULTS: This study included 29,317 individuals with narcolepsy (mean age 41.4 years, 62.1% female, 77.8% White) and 11,951 with IH (mean age 41.7 years, 66.4% female, 81.1% White); 57.9% (N=16,970) and 62.2% (N=7,436) were higher-risk, respectively. Mean follow-up was similar between risk groups (narcolepsy: 3.2 vs 3.3 years; IH: 3.1 vs 3.2 years). Annual mean outpatient visits were greater among higher-risk individuals (narcolepsy: 29.2 vs 18.3, incidence rate ratio [IRR]=1.60, 95% confidence interval [CI]=1.56-1.64; IH: 27.0 vs 19.2, IRR=1.41, 95% CI=1.36-1.45). Annual mean inpatient days (narcolepsy: 2.44 vs 0.57, IRR=4.25, 95% CI=3.61-5.01; IH: 1.10 vs 0.34, IRR=3.18, 95% CI=2.42-4.17) and emergency department visits (narcolepsy: 1.26 vs 0.77, IRR=1.64, 95% CI=1.53-1.75; IH: 1.00 vs 0.65, IRR=1.58, 95% CI=1.44-1.73) were greater among higher-risk individuals. Annual mean medical costs (narcolepsy: $21,716 vs $10,542, mean difference [MD]=$11,174, 95% CI=$10,454-$11,895; IH: $17,635 vs $10,174, MD=$7,461, 95% CI=$6,630-$8,293) and pharmacy costs (narcolepsy: $13,681 vs $10,807, MD=$2,874, 95% CI=$2,028-$3,721; IH: $8,700 vs $5,026, MD=$3,674, 95% CI=$2,919-$4,429) were higher for higher-risk individuals.
CONCLUSIONS: Findings highlight elevated economic burden for individuals with narcolepsy or IH at higher-risk of sodium-associated negative clinical outcomes, emphasizing risk management to mitigate avoidable HCRU and costs.
METHODS: Continuously-enrolled individuals with narcolepsy or IH were identified from Komodo Research Data (01/01/2016-01/31/2024). Individuals with ≥1 cardiovascular, cardiometabolic, or renal sodium-associated risk factor (defined through literature review/clinical expert discussion) in the 12-month pre-index period (index: first-observed narcolepsy/IH diagnosis) were categorized “higher-risk;” “lower-risk” individuals had no risk factors. Annualized all-cause HCRU and costs (2024 USD) over the ≥12-month post-index period were compared between risk groups using log link generalized linear models with negative binomial and gamma distributions, respectively.
RESULTS: This study included 29,317 individuals with narcolepsy (mean age 41.4 years, 62.1% female, 77.8% White) and 11,951 with IH (mean age 41.7 years, 66.4% female, 81.1% White); 57.9% (N=16,970) and 62.2% (N=7,436) were higher-risk, respectively. Mean follow-up was similar between risk groups (narcolepsy: 3.2 vs 3.3 years; IH: 3.1 vs 3.2 years). Annual mean outpatient visits were greater among higher-risk individuals (narcolepsy: 29.2 vs 18.3, incidence rate ratio [IRR]=1.60, 95% confidence interval [CI]=1.56-1.64; IH: 27.0 vs 19.2, IRR=1.41, 95% CI=1.36-1.45). Annual mean inpatient days (narcolepsy: 2.44 vs 0.57, IRR=4.25, 95% CI=3.61-5.01; IH: 1.10 vs 0.34, IRR=3.18, 95% CI=2.42-4.17) and emergency department visits (narcolepsy: 1.26 vs 0.77, IRR=1.64, 95% CI=1.53-1.75; IH: 1.00 vs 0.65, IRR=1.58, 95% CI=1.44-1.73) were greater among higher-risk individuals. Annual mean medical costs (narcolepsy: $21,716 vs $10,542, mean difference [MD]=$11,174, 95% CI=$10,454-$11,895; IH: $17,635 vs $10,174, MD=$7,461, 95% CI=$6,630-$8,293) and pharmacy costs (narcolepsy: $13,681 vs $10,807, MD=$2,874, 95% CI=$2,028-$3,721; IH: $8,700 vs $5,026, MD=$3,674, 95% CI=$2,919-$4,429) were higher for higher-risk individuals.
CONCLUSIONS: Findings highlight elevated economic burden for individuals with narcolepsy or IH at higher-risk of sodium-associated negative clinical outcomes, emphasizing risk management to mitigate avoidable HCRU and costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE16
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Neurological Disorders