Impact of Early Initiation of Eslicarbazepine Acetate on Economic Outcomes Among Patients with Focal Seizure: Results fr
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ORIGINAL RESEARCH
Impact of Early Initiation of Eslicarbazepine Acetate on Economic Outcomes Among Patients with Focal Seizure: Results from Retrospective Database Analyses Darshan Mehta
. Matthew Davis . Andrew J. Epstein .
Brian Wensel . Todd Grinnell . G. Rhys Williams
Received: August 11, 2020 / Accepted: September 3, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: This study assessed the association between early initiation of eslicarbazepine acetate (ESL) as first-line therapy (1L cohort) or as first adjunctive regimen to either levetiracetam (LEV) or lamotrigine (LTG) (add-on cohort), and healthcare resource utilization (HCRU) and charges among adults with treated focal seizures (FS). Methods: This retrospective, longitudinal cohort analysis used Symphony Health’s Integrated Dataverse (IDVÒ) claims data to identify patients aged C 18 years with a diagnosis of FS who had a new prescription for ESL between April 2015 and June 2018. Baseline was the 90-day period immediately prior to the date of the first-dispensed claim for ESL (index date) with a follow-up of 1–4 consecutive 90-day Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12906863. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40120020-00211-6) contains supplementary material, which is available to authorized users. D. Mehta (&) B. Wensel T. Grinnell G. R. Williams Sunovion Pharmaceuticals Inc., 84 Waterford Drive, Marlborough, MA 01752, USA e-mail: [email protected] M. Davis A. J. Epstein Medicus Economics, LLC, Milton, MA, USA
periods. Linear regression models were estimated to assess changes in HCRU and charge outcomes. Results: There were 274 and 153 patients who received ESL in the 1L cohort and add-on cohort, respectively. The 1L cohort experienced significant reductions from baseline during follow-up in all-cause inpatient (IP; P \ 0.0001), emergency room (ER; P \ 0.0001), and outpatient (OP; P \ 0.0001) visits; FS-related IP (P = 0.006) and OP (P \ 0.0001) visits; total, medical, all-cause ER and OP, and FS-related medical charges (P \ 0.05); and significant increases in total prescription and anti-seizure drug (ASD)-related prescription (P \ 0.001) charges. The add-on cohort experienced significant reductions in all-cause IP (P = 0.009) and all-cause and FS-related OP visits (P \ 0.0001 for both) and significant increases in total prescription and ASD-related prescription (P \ 0.001) charges during the follow-up period. In both cohorts, the increases in prescription charges were smaller than the reduction in total medical charges. Conclusion: Early initiation of ESL as 1L or addon therapy was associated with statistically significant reductions in all-cause IP and all-cause and FS-related OP visits during follow-up compared to baseline. The 1L cohort also had statistically significant reductions in all-cause ER visits, FS-related IP visits, and total, medical, allcause ER and OP, and FS-related medical charges.
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