title: Health care resource utilization and costs associated with restless legs syndrome among managed care enrollees treated with dopamine agonists.
abstract: OBJECTIVE
  This study assessed the direct economic burden of restless legs syndrome (RLS) among patients treated with dopamine agonists (DAs) using a large United States managed care database.
  
  
  METHODS
  Retrospective database analysis.
  
  
  METHODS
  Patients were required to have > or =1 prescriptions for a DA (i.e., pergolide, pramipexole, ropinirole) between 1/1/2005 and 12/31/2007 (date of first DA, or "index"); continuous enrollment for > or =6 months before and > or =12 months after index; > or =1 diagnosis of RLS, before and after index; and no diagnosis of Parkinson's disease. Study measures included annual all-cause and RLS-related costs by care setting (hospitalizations, emergency room, office, pharmacy, other, total) and treatment-pattern events (discontinuations, switches, adjunctive treatments, titrations).
  
  
  RESULTS
  A total of 7,796 patients met the inclusion criteria. About 70% of patients received ropinirole, and 30% received pramipexole at index. Approximately 91% had >1 RLS-related office visits, and patients filled an average of 6.5 RLS-related prescriptions (DAs, gabapentin, carbidopa/levodopa) during the 1-year follow-up period. Mean (SD) all-cause health care costs were $11,485 ($21,362) per patient, mostly due to multiple medical conditions occurring with RLS. RLS-related costs were 6.7% of total all-cause costs (mean [SD] $774 [$1,504]), consisting of office visits (16%), pharmacy (63%), and other costs (20%). Approximately 58% had a treatment-pattern event suggesting a dopamine-related side effect. Opioids were the most commonly used adjunctive therapy (13% of patients).
  
  
  CONCLUSIONS
  We found relatively low costs associated with RLS treatment. These findings should encourage expanding the coverage of treatment to reduce the suffering and costs associated with RLS.
authors.affiliation: RTI Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC 27709, USA. jmeyers@rti.org
authors.forename: Juliana
authors.initials: J
authors.lastname: Meyers
authors.forename: Sean
authors.initials: S
authors.lastname: Candrilli
authors.forename: Richard
authors.initials: R
authors.lastname: Allen
authors.forename: Ranjani
authors.initials: R
authors.lastname: Manjunath
authors.forename: Michael
authors.initials: M
authors.lastname: Calloway
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018491:Dopamine Agonists / Q000191:economics / Q000627:therapeutic use; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012148:Restless Legs Syndrome / Q000188:drug therapy / Q000191:economics; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
chemical_list: D018491:Dopamine Agonists