Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep;7(6):334-40.

Healthcare costs among patients with excessive sleepiness associated with obstructive sleep apnea, shift work disorder, or narcolepsy

Rashad Carlton  1 , Orsolya Lunacsek  2 , Timothy Regan  3 , Cathryn A Carroll  4
Affiliations

Healthcare costs among patients with excessive sleepiness associated with obstructive sleep apnea, shift work disorder, or narcolepsy

Rashad Carlton et al. Am Health Drug Benefits. 2014 Sep.

Abstract

Background: Excessive daytime sleepiness affects nearly 20% of the general population and is associated with many medical conditions, including shift work disorder (SWD), obstructive sleep apnea (OSA), and narcolepsy. Excessive sleepiness imposes a significant clinical, quality-of-life, safety, and economic burden on society.

Objective: To compare healthcare costs for patients receiving initial therapy with armodafinil or with modafinil for the treatment of excessive sleepiness associated with OSA, SWD, or narcolepsy.

Methods: A retrospective cohort analysis of medical and pharmacy claims was conducted using the IMS LifeLink Health Plan Claims Database. Patients aged ≥18 years who had a pharmacy claim for armodafinil or for modafinil between June 1, 2009, and February 28, 2012, and had 6 months of continuous eligibility before the index prescription date, as well as International Classification of Diseases, Ninth Revision diagnosis for either OSA (327.23), SWD (327.36), or narcolepsy (347.0x) were included in the study. Patients were placed into 1 of 2 treatment cohorts based on their index prescription and followed for 1 month minimum and 34 months maximum. The annualized all-cause costs were calculated by multiplying the average per-month medical and pharmacy costs for each patient by 12 months. The daily average consumption (DACON) for armodafinil or for modafinil was calculated by dividing the total units dispensed of either drug by the prescription days supply.

Results: A total of 5693 patients receiving armodafinil and 9212 patients receiving modafinil were included in this study. A lower DACON was observed for armodafinil (1.04) compared with modafinil (1.47). The postindex mean medical costs were significantly lower for the armodafinil cohort compared with the modafinil cohort after adjusting for baseline differences ($11,363 vs $13,775, respectively; P = .005). The mean monthly drug-specific pharmacy costs were lower for the armodafinil cohort compared with the modafinil cohort ($166 vs $326, respectively; P <.001). In addition, lower total healthcare costs were observed for the armodafinil cohort compared with the modafinil cohort after correcting for baseline differences ($18,309 vs $23,530, respectively; P <.001).

Conclusion: As shown in this analysis, armodafinil may have real-world DACON advantages and may be associated with lower overall healthcare costs compared with modafinil.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Analysis Timeline
Figure 2
Figure 2. DACON for Armodafinil versus Modafinil
Figure 3
Figure 3. Mean Annualized Medical Costs: Armodafinil versus Modafinil
Figure 4
Figure 4. Postindex Mean Annualized Total Costs: Armodafinil versus Modafinil
See this image and copyright information in PMC

References

    1. Janson C, Gislason T, De Backer W, et al.Daytime sleepiness, snoring and gastro-oesophageal reflux amongst young adults in three European countries. J Intern Med. 1995; 237: 277–285. - PubMed
    1. American Academy of Sleep Medicine. International Classification of Sleep Disorders: Diagnostic and Coding Manual. 2nd ed.Westchester, IL: American Academy of Sleep Medicine; 2005.
    1. Schwartz JR, Roth T, Drake C. Armodafinil in the treatment of sleep/wake disorders. Neuropsychiatr Dis Treat. 2010; 6: 417–427. - PMC - PubMed
    1. National Sleep Foundation. State of the states report on drowsy driving. November 2007. Updated August 2008. http://drowsydriving.org/docs/2007%20State%20of%20the%20States%20Report.pdf. Accessed August 9, 2013.
    1. Drake CL, Roehrs T, Richardson G, et al.Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers. Sleep. 2004; 27: 1453–1462. - PubMed

LinkOut - more resources