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Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant

INTRODUCTION: Insomnia diagnosis has been associated with a significant clinical and economic burden on patients and healthcare systems. This study examined changes in healthcare resource use (HCRU) and costs in insomnia patients before and after initiation of suvorexant treatment. METHODS: This ret...

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Autores principales: Kale, Hrishikesh P., Qureshi, Zaina P., Shah, Ruchit, Khandker, Rezaul, Botteman, Marc, Meng, Weilin, Benca, Ruth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478735/
https://www.ncbi.nlm.nih.gov/pubmed/34463922
http://dx.doi.org/10.1007/s12325-021-01891-8
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author Kale, Hrishikesh P.
Qureshi, Zaina P.
Shah, Ruchit
Khandker, Rezaul
Botteman, Marc
Meng, Weilin
Benca, Ruth
author_facet Kale, Hrishikesh P.
Qureshi, Zaina P.
Shah, Ruchit
Khandker, Rezaul
Botteman, Marc
Meng, Weilin
Benca, Ruth
author_sort Kale, Hrishikesh P.
collection PubMed
description INTRODUCTION: Insomnia diagnosis has been associated with a significant clinical and economic burden on patients and healthcare systems. This study examined changes in healthcare resource use (HCRU) and costs in insomnia patients before and after initiation of suvorexant treatment. METHODS: This retrospective cohort study analyzed Optum Clinformatics Data Mart claims data (Jan 2010–Dec 2018). Patients with ≥ 2 insomnia diagnosis claims and ≥ 1 prescription for suvorexant were included. Prevalent and incident insomnia patients were analyzed separately. The change in the trends of HCRU and costs were examined for 12 months before and 12 months after suvorexant initiation. An interrupted time series (ITS) analysis was conducted to assess the level and slope changes. Subgroups of patients with mental health comorbidities were examined. RESULTS: The study included 18,919 and 5939 patients in the prevalent and incident insomnia cohorts, respectively. For the prevalent cohort, mean (SD) age was 64.5 (14.1) years, 65% were female, 74% had Medicare Advantage coverage, and 61% had a Charlson comorbidity index score ≥ 1. Characteristics for the incident cohort were similar. The ITS results suggested that the trend for monthly total healthcare cost (THC) was increasing before suvorexant initiation (US$52.51 in the prevalent cohort, $74.93 in incident insomnia cohort), but, after suvorexant initiation, the monthly total cost showed a decreasing trend in both cohorts. The decrease in slope for THC after suvorexant initiation were $72.66 and $112.07 per month in the prevalent and incident cohorts, respectively. The monthly trends in HCRU rates also decreased. The subgroup analysis showed that decreases were 1.5–3 times greater for patients with mental health comorbidities. CONCLUSIONS: In this real-world study, suvorexant initiation was associated with immediate and continued decreases in HCRU and costs in insomnia patients. Further research is needed to understand the effect of suvorexant initiation on direct medical costs as well as costs associated with lost productivity in other real-world settings. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-01891-8.
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spelling pubmed-84787352021-10-08 Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant Kale, Hrishikesh P. Qureshi, Zaina P. Shah, Ruchit Khandker, Rezaul Botteman, Marc Meng, Weilin Benca, Ruth Adv Ther Original Research INTRODUCTION: Insomnia diagnosis has been associated with a significant clinical and economic burden on patients and healthcare systems. This study examined changes in healthcare resource use (HCRU) and costs in insomnia patients before and after initiation of suvorexant treatment. METHODS: This retrospective cohort study analyzed Optum Clinformatics Data Mart claims data (Jan 2010–Dec 2018). Patients with ≥ 2 insomnia diagnosis claims and ≥ 1 prescription for suvorexant were included. Prevalent and incident insomnia patients were analyzed separately. The change in the trends of HCRU and costs were examined for 12 months before and 12 months after suvorexant initiation. An interrupted time series (ITS) analysis was conducted to assess the level and slope changes. Subgroups of patients with mental health comorbidities were examined. RESULTS: The study included 18,919 and 5939 patients in the prevalent and incident insomnia cohorts, respectively. For the prevalent cohort, mean (SD) age was 64.5 (14.1) years, 65% were female, 74% had Medicare Advantage coverage, and 61% had a Charlson comorbidity index score ≥ 1. Characteristics for the incident cohort were similar. The ITS results suggested that the trend for monthly total healthcare cost (THC) was increasing before suvorexant initiation (US$52.51 in the prevalent cohort, $74.93 in incident insomnia cohort), but, after suvorexant initiation, the monthly total cost showed a decreasing trend in both cohorts. The decrease in slope for THC after suvorexant initiation were $72.66 and $112.07 per month in the prevalent and incident cohorts, respectively. The monthly trends in HCRU rates also decreased. The subgroup analysis showed that decreases were 1.5–3 times greater for patients with mental health comorbidities. CONCLUSIONS: In this real-world study, suvorexant initiation was associated with immediate and continued decreases in HCRU and costs in insomnia patients. Further research is needed to understand the effect of suvorexant initiation on direct medical costs as well as costs associated with lost productivity in other real-world settings. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-021-01891-8. Springer Healthcare 2021-08-31 2021 /pmc/articles/PMC8478735/ /pubmed/34463922 http://dx.doi.org/10.1007/s12325-021-01891-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Kale, Hrishikesh P.
Qureshi, Zaina P.
Shah, Ruchit
Khandker, Rezaul
Botteman, Marc
Meng, Weilin
Benca, Ruth
Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant
title Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant
title_full Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant
title_fullStr Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant
title_full_unstemmed Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant
title_short Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant
title_sort changes in healthcare resource use and costs in commercially insured insomnia patients initiating suvorexant
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478735/
https://www.ncbi.nlm.nih.gov/pubmed/34463922
http://dx.doi.org/10.1007/s12325-021-01891-8
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