Healthcare Resource Utilization Pre- and Post-Initiation of Eslicarbazepine Acetate Among Pediatric Patients with Focal Seizure: Evidence from Routine Clinical Practice

摘要

Objective: To examine the impact of initiating treatment with eslicarbazepine acetate (ESL) on healthcare resource utilization (HCRU) among pediatric patients with focal seizures (FS). Methods: This retrospective study used Symphony Health’s Integrated Dataverse? claims data. Patients aged 4 to 17 years with a diagnosis of FS and a new prescription for ESL between April 2015 and June 2018 were included and defined as the overall patient population. Index date was the first dispensed claim for ESL. Baseline period was the 90-day block immediately prior to the index date. The follow-up period comprised up to 4 consecutive 90-day blocks immediately following the index date. Subgroups were defined based on the presence (DP ) or absence (DP?) of developmental and/or psychiatric disorders at baseline. All-cause and FS-related inpatient (IP), emergency room (ER), outpatient (OP) hospital, and office (OF) visits were measured during the follow-up period. Reduction in HCRU per block in the post-ESL period was assessed using fixed-effects linear regression models. Results: A total of 234 patients were included in the overall study population, of whom 86 (36.8%) were DP and 148 (63.2%) were DP?. Relative to the baseline period, significant reductions were observed in the overall population for all-cause ER ( P =0.001), OP ( P 0.001), and OF (P 0.001) visits and FS-related IP ( P =0.037) and OF ( P 0.001) visits in the follow-up period. Among DP and DP? patients, significant reductions were observed for all-cause ER (DP : P =0.024; DP?: P =0.017), OP (DP : P 0.001; DP?: P =0.035), and OF (DP : P =0.004; DP?: P =0.001) visits during the follow-up period. No significant differences were observed between DP and DP? patients in the change in all-cause or FS-related HCRU from baseline to the follow-up period. Conclusion: Pediatric patients with FS (DP and DP-) who initiated ESL had significant reductions in all-cause ER, OP, and OF visits and FS-related IP and OF visits.