title: Outcomes associated with switching from monotherapy to adjunctive therapy for patients with partial onset seizures.
abstract: BACKGROUND
  Some patients with partial onset seizures are drug-resistant and may benefit from adjunctive therapy. This study evaluated monotherapy/sequential monotherapy versus adjunctive therapy on use/costs.
  
  
  METHODS
  Retrospective analysis using commercial/Medicare database (1 January 2007 to 31 December 2009). Patients with ≥2 diagnoses for partial onset seizures who received ≥2 prescriptions of the same antiepileptic drug were included. Outcomes assessed in the 12-month follow-up period were hospitalizations, ER visits, outpatient visits and prescription costs for patients who received monotherapy but switched to adjunctive.
  
  
  RESULTS
  1353 patients met criteria. After patients transitioned to adjunctive therapy, the average monthly percentage of patients with a hospitalization decreased from 5.3 to 3.0% (p < 0.0001). Similar results occurred with epilepsy-related hospitalizations (4.0 vs 1.7%, p < 0.0001). Adjusted costs decreased significantly (US$4205 vs 2944/month, p < 0.0001). Adjusted epilepsy-related costs decreased from US$1601 to 909/month (p < 0.0001).
  
  
  CONCLUSIONS
  Adjunctive therapy in potentially drug-resistant patients with partial onset seizures can lead to reduced healthcare use and costs.
authors.affiliation: Eisai, Health Economics and Outcomes Research, 100 Tice Blvd, Woodcliff Lake, NJ 07677, USA.
authors.forename: Zhixiao
authors.initials: Z
authors.lastname: Wang
authors.forename: Xuan
authors.initials: X
authors.lastname: Li
authors.forename: Annette
authors.initials: A
authors.lastname: Powers
authors.forename: Jose E
authors.initials: JE
authors.lastname: Cavazos
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: adjunctive therapy; anti-epileptic drugs; epilepsy; partial onset seizures; sequential monotherapy