The Clinical and Economic Burden of Idiopathic Hypersomnia: Results from the Real-World Idiopathic Hypersomnia Total Health Model (RHYTHM) Study.

Abstract

Purpose: Limited research describes the clinical and economic burden of idiopathic hypersomnia. This study compared this burden in individuals with idiopathic hypersomnia against matched controls.

Patients and methods: This retrospective cohort study analyzed Merative™ MarketScan^® US claims (12/31/2013-2/29/2020). Individuals were ≥18 years of age and continuously enrolled during a 2-year assessment period. Individuals with idiopathic hypersomnia entered the cohort upon their first idiopathic hypersomnia medical claim; they were matched 1:5 with non-idiopathic hypersomnia controls on age, sex, region, insurance type, and cohort entry date. Odds of comorbid conditions experienced by individuals in either cohort during the 2-year assessment were compared. Healthcare resource utilization (HCRU) was presented as percentages by care setting. Median medical cost per patient per year (PPPY) was the sum of inpatient, outpatient, and emergency costs. P-values were not adjusted for multiplicity.

Results: This analysis included 11,412 individuals with idiopathic hypersomnia and 57,058 matched controls. In both cohorts, median age was 45 years and 65% of individuals were female. Compared with matched controls, individuals with idiopathic hypersomnia had 1.6- to 4.4-fold higher odds (all P<0.0001) of grouped conditions defined by multilevel Clinical Classifications Software categories, from neoplasms to nervous systems diseases, including sleep-related conditions. Individuals with idiopathic hypersomnia had higher odds of all comorbid conditions evaluated, including sleep-related, cardiovascular and cardiometabolic, and neuropsychiatric conditions, compared with matched controls. Individuals with idiopathic hypersomnia had higher HCRU (outpatient, 100% vs 96.1%; emergency department, 46.6% vs 34.3%; inpatient, 10.2% vs 8.5%, all P<0.0001) than matched controls. Median medical costs PPPY were higher for individuals with idiopathic hypersomnia ($4854) than matched controls ($1348).

Conclusion: Compared with matched controls, individuals with idiopathic hypersomnia had a higher clinical burden, spanning multiple organ systems, and a higher economic burden. Individuals' clinical profiles may be considered when treating idiopathic hypersomnia and providing holistic care.