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. 2021 Apr 19:13:251-261.
doi: 10.2147/CEOR.S303079. eCollection 2021.

Comparative Economic Outcomes in Patients with Focal Seizure Initiating First-Line Eslicarbazepine Acetate Monotherapy versus Generic Antiseizure Drugs

Darshan Mehta  1 , Matthew Davis  2 , Andrew J Epstein  3 , Brian Wensel  1 , Todd Grinnell  4 , G Rhys Williams  1
Affiliations

Comparative Economic Outcomes in Patients with Focal Seizure Initiating First-Line Eslicarbazepine Acetate Monotherapy versus Generic Antiseizure Drugs

Darshan Mehta et al. Clinicoecon Outcomes Res. .

Abstract

Objective: To examine the association between initiating first-line (1L) monotherapy with eslicarbazepine acetate (ESL) vs a generic antiseizure drug (ASD) and healthcare resource utilization (HCRU) and charges in adults with treated focal seizures (FS).

Methods: This was a retrospective analysis of Symphony Health's Integrated Dataverse® open-source claims data. Two cohorts were identified as having initiated 1L monotherapy with ESL or literature-defined generic ASDs. Linear regression models with person fixed effects and inverse probability treatment weights assessed the relative additional changes in HCRU and charges among patients who received ESL compared to generic ASD.

Results: A total of 250 and 43,220 patients initiated ESL (48.3 years; 57.2% female) or a generic ASD (54.5 years; 58.1% female), respectively. Compared to patients initiating a generic ASD, patients treated with ESL had additional reductions of 11.8 percentage points in the likelihood of any all-cause outpatient visits (P<0.001), 7.4 percentage points in the likelihood of any emergency department (ED) visits (P=0.013), and 22.7 percentage points in the likelihood of any FS-related outpatient visits (P<0.001). Patients initiating ESL had greater reductions in mean charges for all-cause medical ($2620; P=0.002), outpatient ($1995; P=0.005), and non-FS-related medical ($2708; P<0.001) services. Patients initiating ESL had greater relative increases in mean total prescription ($1368; P<0.001) and ASD-related prescription ($1636; P<0.001) charges, but greater relative reductions in non-ASD prescription ($269; P=0.032) charges. The increases in prescription charges were of a lower magnitude than the decreases in medical charges.

Conclusion: Initiation of ESL as 1L monotherapy was associated with statistically significantly greater reductions in any use of several all-cause and FS-related services, number of visits, and charges compared to initiation of a generic ASD as 1L monotherapy in patients with FS. Initiation of a generic ASD as 1L monotherapy was associated with significantly smaller increases in total prescription charges and ASD-related prescription charges.

Keywords: eslicarbazepine acetate; focal seizures; healthcare resource utilization; medical charges.

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Conflict of interest statement

DM, BW, TG, and GRW are employees of Sunovion Pharmaceuticals Inc. MD and AJE are employees of Medicus Economics, LLC, which received funding from Sunovion Pharmaceuticals Inc. to participate in this research. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study design.
Figure 2
Figure 2
Sample selection.
Figure 3
Figure 3
Relative additional change in any HCRU (A), number of days of HCRU (B), or charges (C) for patients initiating ESL as monotherapy compared to a generic ASD. All outcomes were measured over 90 day periods. (A) Any HCRU. (B) Number of days of HCRU. (C) Charges. * P<0.05 ESL vs generic ASD.
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