CLINICAL AND ECONOMICAL BURDEN OF CHRONIC SEDATIVE-HYPNOTIC USE FOR INSOMNIA DISORDER: A NATIONWIDE FRENCH CLAIMS DATABASE STUDY
Author(s)
Pierre Alexis Geoffroy, PhD1, Jean-Louis Pepin, PhD2, Sylvaine Barbier, MSc3, Claire Leboucher4, Emily Robertshaw, MsC5, Raphaëlle Winsky-Sommerer, MsC6, Isabelle BORGET, PharmD, PhD7, Yves Dauvilliers, PhD8.
11Psychiatry and Addiction Department, AP-HP GHU Paris Nord; Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France, 2Grenoble Alpes University, HP2-Inserm U1300, Grenoble, France, 3Inizio Ignite, Putnam, Creativ-Ceutical, Lyon, United Kingdom, 4Senior Consultant, Putnam, Paris, France, 5Inizio Ignite, Putnam, Newcastle Upon Tyne, United Kingdom, 6Idorsia Pharmaceuticals France SAS, Paris, France, 7Master2 Market-Access and Economic Evaluation, ORSAY, France, 8Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, Institute of Neuroscience Montpellier, University of Montpellier, INSERM, Montpellier, France.
11Psychiatry and Addiction Department, AP-HP GHU Paris Nord; Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France, 2Grenoble Alpes University, HP2-Inserm U1300, Grenoble, France, 3Inizio Ignite, Putnam, Creativ-Ceutical, Lyon, United Kingdom, 4Senior Consultant, Putnam, Paris, France, 5Inizio Ignite, Putnam, Newcastle Upon Tyne, United Kingdom, 6Idorsia Pharmaceuticals France SAS, Paris, France, 7Master2 Market-Access and Economic Evaluation, ORSAY, France, 8Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, Institute of Neuroscience Montpellier, University of Montpellier, INSERM, Montpellier, France.
OBJECTIVES: Insomnia disorder (INS) is highly prevalent and associated with multiple comorbidities, impaired quality of life, and has substantial economic burden. The study objective was to describe the real-world clinical and healthcare impact of insomnia in patients with regular use of sedative-hypnotics compared with a control population without insomnia medications.
METHODS: Adult patients with regular dispensations of sedative-hypnotics (≥3 packs/year; INS cohort) in 2017 were included using the 2% sample representative of the French National Health Data System. The INS cohort was 1:3 matched to a control group with no dispensation of sedative-hypnotics (NoINS cohort). Both were followed until 2019. Descriptive statistics and effect sizes were used to characterize comorbidity occurrence, healthcare resource utilisation, reimbursed costs and sick leaves. Survival was analysed using a Cox model.
RESULTS: Before matching, the INS and NoINS cohorts included 18,772 and 450,410 patients (mean age 64.3 vs. 46.6; 67% vs. 55% women). After matching, the INS and NoINS cohorts included 11,691 and 35,073 patients (mean age 64; 69% women). INS patients had an increased risk of comorbidities, in particular depression, addictions, and anxiety. Healthcare utilisation was higher with more frequent consultations, hospitalisations, and emergency department visits. INS mean annual direct costs per patient were also higher with a mean cost difference of around 2,300€ (95%CI 2,159-2,417) in 2018 and 2,500€ (95%CI 2,365-2,650) in 2019. The risk of having sick leaves was higher in the INS cohort (2017 OR 95%CI: 1.42 [1.31-1.55], 2018: 1.33 33 [1.22-1.45], 2019: 1.26 [1.15-1.38]). Survival was higher in the NoINS cohort (HR: 1.23 [1.15-1.33]).
CONCLUSIONS: A substantial multidimensional burden with increased healthcare utilization and reimbursed costs was associated with INS for patients with regular use of sedative-hypnotics, as well as reduced productivity. Addressing this burden will require broader access to effective treatments and integrated models of care.
METHODS: Adult patients with regular dispensations of sedative-hypnotics (≥3 packs/year; INS cohort) in 2017 were included using the 2% sample representative of the French National Health Data System. The INS cohort was 1:3 matched to a control group with no dispensation of sedative-hypnotics (NoINS cohort). Both were followed until 2019. Descriptive statistics and effect sizes were used to characterize comorbidity occurrence, healthcare resource utilisation, reimbursed costs and sick leaves. Survival was analysed using a Cox model.
RESULTS: Before matching, the INS and NoINS cohorts included 18,772 and 450,410 patients (mean age 64.3 vs. 46.6; 67% vs. 55% women). After matching, the INS and NoINS cohorts included 11,691 and 35,073 patients (mean age 64; 69% women). INS patients had an increased risk of comorbidities, in particular depression, addictions, and anxiety. Healthcare utilisation was higher with more frequent consultations, hospitalisations, and emergency department visits. INS mean annual direct costs per patient were also higher with a mean cost difference of around 2,300€ (95%CI 2,159-2,417) in 2018 and 2,500€ (95%CI 2,365-2,650) in 2019. The risk of having sick leaves was higher in the INS cohort (2017 OR 95%CI: 1.42 [1.31-1.55], 2018: 1.33 33 [1.22-1.45], 2019: 1.26 [1.15-1.38]). Survival was higher in the NoINS cohort (HR: 1.23 [1.15-1.33]).
CONCLUSIONS: A substantial multidimensional burden with increased healthcare utilization and reimbursed costs was associated with INS for patients with regular use of sedative-hypnotics, as well as reduced productivity. Addressing this burden will require broader access to effective treatments and integrated models of care.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD88
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Mental Health (including addiction)