Abstracts

Newer antiepileptic drugs (AEDs) offer many alternatives in the treatment of epilepsy, including broad spectrum efficacy, unique mechanisms of action, and tolerable adverse effect profiles. Data for patients newly initiatied on AEDs were retrospectively assessed to examine differences in overall healthcare costs (inpatient, emergency room, outpatient, prescriptions) including treatment costs, monitoring, and costs related to adverse events. The 1999-2003Q1 MarketScan Commercial Claims and Encounter Database of health insurance claims for employees/dependents affiliated with large Fortune 500 companies was used to identify adult patients diagnosed with epilepsy and newly initiating on newer AEDs (lamotrigine, oxcarbazepine, levetiracetam, topiramate, felbamate, gabapentin, tiagabine, and zonisamide). Patients were followed from initiation of AED treatment until termination of enrollment or administrative close of the database. Demographics, comorbid conditions, healthcare resource utilization, and healthcare costs were collected and compared between AED and versus matched non-epileptic patients. The study sample (n=7,050) was 38% male, with a mean age of 44 years, and had an average length of follow-up of 1.5 years. Amongst the newer AEDs, median annualized total healthcare costs were significantly lower (t-test, all p[lt]0.05) for lamotrigine ($5,592), as compared to oxcarbazepine ($7,480), levitiractam ($9,829) topiramate ($9,309), and the other newer AEDs ($13,127). The primary drivers of differences in costs between AEDs were variances in outpatient care and pharmaceutical expenditures. For comparison, the median annualized healthcare costs for a matched non-epileptic population was ($1,726). Compared to the non-epileptic population, healthcare costs are approximately 5 times higher for persons with epilepsy newly initiating anewer AED. Among newer AEDs, annual healthcare costs vary substantially by type of treatment prescribed. Research is underway to further examine these costs, including controlling for differences in baseline demographic and comorbidity characteristics across newer AED therapies [ndash] this work will be presented. (Supported by GlaxoSmithKline Inc.)