ECONOMIC BURDEN OF PROBABLE LENNOX-GASTAUT SYNDROME, PROBABLE DRAVET SYNDROME, AND OTHER REFRACTORY EPILEPSIES FOR UNITED STATES COMMERCIAL HEALTH PLANS
Author(s)
Stockl K1, Hollenack KA1, Acs A2, Tran O3, Krol J1, Story TJ1
1Greenwich Biosciences, Inc., Carlsbad, CA, USA, 2IBM Watson Health, Bethesda, MD, USA, 3IBM Watson Health, San Francisco, CA, USA
Presentation Documents
OBJECTIVES Previous studies of healthcare costs for patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) were conducted before or shortly after the availability of newer antiepileptic drugs (AEDs). This study updates previous analyses of the direct cost burden of probable LGS, probable DS, and other refractory epilepsies using more recent data from US commercial health plans. METHODS Using the IBM® MarketScan® Commercial database, continuously-enrolled patients were identified if they had ≥1 AED claim and medical claims with ≥1 diagnosis code for LGS or refractory epilepsy or ≥1 claim for clobazam or rufinamide between 10/1/2015 and 03/31/2016. A previously-developed algorithm was used to stratify patients into 3 cohorts: probable LGS, probable DS, or other refractory epilepsies. All-cause and epilepsy-related healthcare costs were measured over the 12-month post-index period following each patient’s earliest diagnosis or AED claim (index date). RESULTS Of 8,196 patients identified, 1,296 were classified as probable LGS, 183 as probable DS, and 6,717 as other refractory epilepsies. Patients with probable LGS or DS were younger than patients with other refractory epilepsies (mean 16.5, 14.5, and 33.5 years, respectively). Number of distinct AEDs during the 12-month pre-index period averaged 3.4, 2.6, and 2.1, respectively. Mean all-cause total healthcare costs were highest for probable LGS ($80,545), followed by probable DS ($77,914), and other refractory epilepsies ($43,794). All-cause medical costs averaged $56,527, $63,850, and $32,403, respectively. The majority of medical costs were epilepsy-related (71.2%, 80.5%, and 62.5%, respectively). Total pharmacy costs averaged $24,018, $14,064, and $11,391 respectively. The majority of pharmacy costs were for AEDs (72.6%, 70.8%, 65.8%, respectively). CONCLUSIONS Results highlight the substantial direct cost burden of probable LGS, probable DS, and other refractory epilepsies for US commercial plans. Total healthcare costs for probable LGS or DS were higher than earlier analyses, with higher per-patient AED costs a contributing factor.
Conference/Value in Health Info
2019-05, ISPOR 2019, New Orleans, LA, USA
Value in Health, Volume 22, Issue S1 (2019 May)
Code
PND27
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Neurological Disorders, Rare and Orphan Diseases