title: Health-care costs and utilization related to long- or short-acting antiepileptic monotherapy use.
abstract: OBJECTIVE
  This study aimed to compare health-care utilization and costs in patients treated with long-acting (LA) vs. short-acting (SA) antiepileptic drug (AED) monotherapy.
  
  
  METHODS
  We conducted a cross-sectional study of claims from the OptumInsight™ database. Our analysis was restricted to adults diagnosed with epilepsy and who used AED monotherapy. Patients were excluded if they used >1 type of AED, had <9months of treatment, or had a treatment gap of >60days. Antiepileptic drugs were classified as LA or SA based on published data and expert opinion. Medical and pharmacy claims were used to estimate health-care utilization and costs, and baseline group differences were adjusted using multivariate analyses.
  
  
  RESULTS
  There were 4058 (49.6%) LA AED users and 4122 (50.4%) SA AED users. Medication possession ratios (MPRs) were not significantly different between LA AED users and SA AED users (P=0.125). Long-acting AED users had lower mean overall health-care costs ($9757 vs. $12,689), lower epilepsy-related costs ($3539 vs. $5279), and lower rate of overall (8.8% vs. 10.9%) and epilepsy-related hospitalizations (5.7% vs. 7.6%) compared with SA AED users (all P<0.01). After adjusting for demographics and clinical characteristics, mean overall costs were lower by $686 and the mean epilepsy-related costs were lower by $894 in LA AED users.
  
  
  CONCLUSIONS
  Although MPRs were similar in LA AED and SA AED groups, patients treated with LA monotherapy had a lower economic burden compared with those treated with SA monotherapy, indicating that using AEDs with extended duration of action is associated with decreased health-care use and lower health-care costs.
authors: 49 Briar Hollow Lane, #1804, Houston, TX 77027, USA. Electronic address: joyce.cramer@gmail.com.
authors: Joyce A
authors: JA
authors: Cramer
authors: Eisai, Inc., 100 Tice Boulevard, Woodcliff Lake, NJ 07677, USA. Electronic address: Jason_Wang@eisai.com.
authors: Zhixiao J
authors: ZJ
authors: Wang
authors: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA 90212, USA. Electronic address: echang@pharllc.com.
authors: Eunice
authors: E
authors: Chang
authors: Eisai, Inc., 100 Tice Boulevard, Woodcliff Lake, NJ 07677, USA. Electronic address: Ronda_Copher@eisai.com.
authors: Ronda
authors: R
authors: Copher
authors: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA 90212, USA. Electronic address: dasha@pharllc.com.
authors: Dasha
authors: D
authors: Cherepanov
authors: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA 90212, USA. Electronic address: mbroder@pharllc.com.
authors: Michael S
authors: MS
authors: Broder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000191:economics* / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004827:Epilepsy / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D055815:Young Adult
chemical_list: D000927:Anticonvulsants
keywords: Adherence; Antiepileptic drugs; Cost analysis; Economics; Epilepsy; Medical care; Seizures