OBJECTIVES: Once-daily armodafinil significantly improves wakefulness in patients with excessive sleepiness due to shift work disorder (SWD), treated obstructive sleep apnea (OSA), or narcolepsy. The objective of the current analysis was to examine resource utilization by patients who received armodafinil for these FDA-approved indications. METHODS: Data were collected from the IMS LifeLink Database (December 2008 to March 2010) and contained longitudinal patient data from medical claims (diagnostic/therapeutic services), pharmacy claims (prescriptions), and eligibility files (demographics and enrollment). Patients were identified and healthcare utilization data were collected for 6 months before and up to 10 months after their first armodafinil pharmacy claim. Healthcare costs and visits before and after initiation of armodafinil were statistically analyzed using paired t-tests. RESULTS: 1,282 patients were included (4.5% SWD; 85.9% OSA; 20.4% narcolepsy). The mean monthly healthcare cost for patients prior to taking armodafinil was $1,562.99 (pharmacy $432.26; medical $1,130.73). After armodafinil initiation, overall monthly cost decreased to $1,438.11 (p=0.0588). Armodafinil significantly increased prescription costs by $138.53/month (p<0.0001) but decreased medical costs by $263.41/month (p<0.0001). Medical costs were decreased by $133.23 for physician costs (p<0.0001) and $75.62 for outpatient costs (p=0.0039). Emergency room costs were lower by $3.99/month (NS), and inpatient costs were lower by $7.51/month (NS). The number of inpatient visits were reduced by 0.21/year (p=0.0307), physician visits by 4.91/year (p<0.0001), and outpatient visits by 0.89/year (p<0.0001). CONCLUSIONS: After armodafinil treatment, reductions were seen in healthcare utilization and costs compared to the pre-armodafinil period. As expected, total prescription costs were greater following initiation of armodafinil therapy; however, lower total monthly costs were observed with armodafinil because use of medical resources decreased. This significant reduction in medical resource utilization appeared to be driven predominantly by fewer physician visits and lower outpatient costs. This research was sponsored by and conducted in collaboration with Cephalon, Inc., Frazer, PA.