The Burden of Narcolepsy Disease (BOND) study: health-care utilization and cost findings.
OBJECTIVE
The aim of this study was to characterize health-care utilization, costs, and productivity in a large population of patients diagnosed with narcolepsy in the United States.


METHODS
This retrospective, observational study using data from the Truven Health Analytics MarketScan Research Databases assessed 5 years of claims data (2006-2010) to compare health-care utilization patterns, productivity, and associated costs among narcolepsy patients (identified by International Classification of Diseases, Ninth Revision (ICD9) narcolepsy diagnosis codes) versus matched controls. A total of 9312 narcolepsy patients (>18 years of age, continuously insured between 2006 and 2010) and 46,559 matched controls were identified.


RESULTS
Compared with controls, narcolepsy subjects had approximately twofold higher annual rates of inpatient admissions (0.15 vs. 0.08), emergency department (ED) visits w/o admission (0.34 vs. 0.17), hospital outpatient (OP) visits (2.8 vs. 1.4), other OP services (7.0 vs. 3.2), and physician visits (11.1 vs. 5.6; all p<0.0001). The rate of total annual drug transactions was doubled in narcolepsy versus controls (26.4 vs. 13.3; p<0.0001), including a 337% and 72% higher usage rate of narcolepsy drugs and non-narcolepsy drugs, respectively (both p<0.0001). Mean yearly costs were significantly higher in narcolepsy compared with controls for medical services ($8346 vs. $4147; p<0.0001) and drugs ($3356 vs. $1114; p<0.0001).


CONCLUSIONS
Narcolepsy was found to be associated with substantial personal and economic burdens, as indicated by significantly higher rates of health-care utilization and medical costs in this large US group of narcolepsy patients.
Stanford University, Palo Alto, CA, USA. Electronic address: jedblack@stanford.edu.
Jed
J
Black
Strategic Health Resources, La Canada, CA, USA.
Nancy L
NL
Reaven
Strategic Health Resources, La Canada, CA, USA.
Susan E
SE
Funk
California Polytechnic State University, San Luis Obispo, CA, USA.
Karen
K
McGaughey
Stanford University, Palo Alto, CA, USA.
Maurice
M
Ohayon
Stanford University, Palo Alto, CA, USA.
Christian
C
Guilleminault
Stanford University, Palo Alto, CA, USA.
Chad
C
Ruoff
Stanford University, Palo Alto, CA, USA.
Emmanuel
E
Mignot
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D016527:Drug Costs / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000188:drug therapy / Q000191:economics*; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Burden of illness; Cataplexy; Cost of illness; Health-care utilization; Narcolepsy; Socioeconomic impact