■研究醋酸埃司卡西平(ESL)与首次辅助治疗之间的关系布立西坦(BRV)对治疗局灶性癫痫发作(FS)患者的医疗资源利用(HCRU)和费用的影响。
SymphonyHealth的综合Dataverse(IDV)声明数据(2015年4月1日至2018年6月30日)用于确定两个队列作为通用抗癫痫药物(ASD)后使用ESL或BRV的第一个辅助治疗。索引日期是最早要求使用新的ESL或BRV处方的日期。关键的纳入标准是在指标日期前的12个月内只有1项通用ASD;≥1项具有FS诊断的医疗索赔。分析单位是90天的人时块。使用差异框架评估HCRU和费用的变化。进行了未调整和调整的分析。调整后的模型利用特定于人的固定效应和基于倾向得分的加权来控制基线协变量的差异。计算费用结果的偏差校正自举置信区间(CI)。
■208和137名患者开始首次使用ESL辅助治疗(43.7年,51.9%女性)或BRV(39.3岁,51.8%女性)。ESL队列中的患者在全因和FS相关的住院和门诊就诊以及FS相关的急诊科就诊数量上有更大的减少。与开始BRV的患者相比,接受ESL治疗的患者的总费用显着降低(-3,446美元,CI:-13,716美元,-425美元),所有原因(-$3,166,CI:-$13,991,-$323)和与FS相关的(-$2,969,CI:-$21,547,-$842)医疗费用,所有原因(-3,397美元,CI:-15,676美元,-818美元)和与FS相关的(-2,863美元,CI:-19,707美元,-787美元)门诊费,和非ASD相关的处方费用(-420美元,CI:-1058美元,-78美元)。
■索赔可能缺失,或错误编码;结果可能受到分析中未考虑的变量的影响;仅包括提交费用的信息。
■在FS患者中,与BRV相比,首次ESL辅助治疗的开始与医疗和非ASD相关处方费用的显著降低相关.
UNASSIGNED: To study the association between initiation of first adjunctive therapy with eslicarbazepine acetate (ESL) vs. brivaracetam (BRV) on healthcare resource utilization (HCRU) and charges among patients with treated focal seizures (FS).
UNASSIGNED: Symphony Health\'s Integrated Dataverse (IDV) claims data (1 April 2015 to 30 June 2018) were used to identify two cohorts as first adjunctive therapy with ESL or BRV following a generic anti-seizure drug (ASD). The index date was the earliest claim for a new ESL or BRV prescription. Key inclusion criteria were only 1 generic ASD in the 12 months before the index date; ≥1 medical claim with an FS diagnosis. Unit of analysis was the 90-day person-time-block. Changes in HCRU and charges were assessed using a difference-in-differences framework. Both unadjusted and adjusted analyses were performed. The adjusted model utilized person-specific fixed effects and propensity score-based weighting to control for differences in baseline covariates. Bias-corrected bootstrap confidence intervals (CIs) were calculated for charge outcomes.
UNASSIGNED: 208 and 137 patients initiated first adjunctive therapy with ESL (43.7 years, 51.9% female) or BRV (39.3 years, 51.8% female). Patients in the ESL cohort had numerically larger reductions in all-cause and FS-related inpatient hospitalizations and outpatient visits and FS-related emergency department visits. Compared to patients initiating BRV, patients treated with ESL had significantly larger reductions in total charges (-$3,446, CI: -$13,716, -$425), all-cause (-$3,166, CI: -$13,991, -$323) and FS-related (-$2,969, CI: -$21,547, -$842) medical charges, all-cause (-$3,397, CI: -$15,676, -$818) and FS-related (-$2,863, CI: -$19,707, -$787) outpatient charges, and non-ASD-related prescription charges (-$420, CI: -$1,058, -$78).
UNASSIGNED: Claims may be missing, or miscoded; outcomes may be influenced by variables not accounted for in the analysis; only information on submitted charges was included.
UNASSIGNED: Among patients with FS, initiation of first adjunctive therapy with ESL was associated with significantly larger reductions in medical and non-ASD-related prescriptions charges compared to BRV.