OBJECTIVES: Previous research has demonstrated the frequency of side effects due to the use of multiple drugs and dose escalation with pharmacotherapy in ET, yet data on economic consequences are limited. This research was designed to evaluate the association of the use of multiple drugs on associated morbidities (AMs), healthcare resource utilization and costs among Medicare patients with essential tremor (ET).

METHODS: Using the MarketScan database (1/1/2017 – 6/30/2020), ET patients were identified and categorized according to treatment with the following commonly prescribed ET medications: propranolol, primidone, gabapentin, topiramate and atenolol. Subgroups of ET patients were created based upon whether they were taking 0, 1, 2 of the pre-defined ET medications. Rates of depression, anxiety and falls were assessed during the two-year period after index date. Healthcare resource utilization (HCRU) and costs were also examined.

RESULTS: In the two years following index date, AMs associated with increased ET medication use were as follows: depression 28.8% vs. 31.5% vs. 36.3% (0, 1, 2 ET medications, respectively); anxiety 28.1% vs. 30.6% vs. 30.5% (0, 1, 2 ET medications, respectively); falls 14.1% vs. 16.3% vs. 21.4% (0, 1, 2 ET medications, respectively). Over the 2 year follow up period, total medication use increased with additional ET medication use: 6.9 vs. 8.6 vs. 9.8 across ET subgroups (0, 1, 2 ET medications, respectively). Rates of all cause inpatient admissions, emergency room visits and costs were 29.6%, 45.1% and $37,300 vs. 34.2%, 49.0% and $50,873 vs. 41.9%, 53.4% and $63,196 (0, 1, 2 ET medications, respectively).

CONCLUSIONS: There was a trend toward higher AMs following the index date as ET medication use increased. Additionally, HCRU and costs increased as patients took additional ET medications. ET patients may benefit from safe and effective non-pharmacologic therapies to avoid adverse events and costs.