title: Prevalence and cost of insomnia in a state Medicaid fee-for-service population based on diagnostic codes and prescription utilization.
abstract: OBJECTIVE
  The aims of this research were to estimate prevalence of insomnia, describe the utilization patterns of physician office services and prescription medications for insomnia, and estimate related costs in a Medicaid population.
  
  
  METHODS
  A cross-sectional descriptive analysis using data from the West Virginia (WV) Medicaid fee-for-service paid claims records for the year 2003 was conducted. Recipients with a diagnosis related to insomnia or a prescription claim for an FDA-approved drug for insomnia or trazodone were selected as the study sample. Costs were from the perspective of WV Medicaid.
  
  
  RESULTS
  The overall prevalence of insomnia was 74.3 per 1000 recipients. Adults 45-64years of age, females, and whites had the highest prevalence and office visit rates for insomnia among demographic groups. A majority of dollars spent on insomnia treatment was for prescription drugs. Zolpidem and trazodone accounted for 88% of prescription claims; however, 84% of the total dollars paid for prescriptions was for zolpidem.
  
  
  CONCLUSIONS
  Among the WV Medicaid population, rates of insomnia and office visit use for insomnia varied by demographic groups. There was greater use of zolpidem and trazodone than benzodiazepine drugs. This study provides baseline estimates that can be used for ongoing surveillance of insomnia.
authors.affiliation: Global Health Economics & Outcomes Research, Takeda Pharmaceuticals Inc., One Takeda Parkway, Deerfield, IL 60015, USA. aroy@tpna.com
authors.forename: Anuja N
authors.initials: AN
authors.lastname: Roy
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D014151:Anti-Anxiety Agents / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000191:economics* / Q000706:statistics & numerical data*; D018588:Fee-for-Service Plans / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011725:Pyridines / Q000191:economics / Q000627:therapeutic use; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology*; D014196:Trazodone / Q000191:economics / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology; D014903:West Virginia / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult; D000077334:Zolpidem
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D011725:Pyridines; D000077334:Zolpidem; D014196:Trazodone