Characterization of Economic Burden in Individuals With Narcolepsy or Idiopathic Hypersomnia at Higher Risk of Sodium-Associated Negative Clinical Outcomes in the United States
Moderator
Silky W Beaty, MSPH, PharmD, Jazz Pharmaceuticals, Tucker, GA, United States
Speakers
Caroleen Drachenberg, MSPH, PhD, Jazz pharmaceuticals, Palo Alto, CA, United States; Sarah Markt, Jazz pharmaceuticals, Shaker Heights, OH, United States; Lee Surkin; Richard J Kovacs; Kaitlyn Easson; Jessica Alexander; Patrick Gagnon-Sanschagrin; Marisa Whalen; Remi Bellefleur; Mohira Levesque-Leroux; Annie Guerin; Pam Taub
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