The Clinical and Economic Burden of Idiopathic Hypersomnia and Narcolepsy: A United States Claims-Based Analysis.

Abstract

Purpose: Idiopathic hypersomnia and narcolepsy are similar but distinct sleep disorders. This study evaluated the clinical and economic burden experienced by individuals with either condition.

Patients and methods: Merative^™ MarketScan^® Research Databases claims were analyzed (study period, 12/31/2013-2/29/2020). Eligible individuals were ≥18 years of age, continuously enrolled (365 days before/after cohort entry), and had a claim for either condition. Those with cataplexy were excluded from the idiopathic hypersomnia cohort. Individuals entered cohorts upon their earliest claim for their condition during the study period. Clinical classification categories, select conditions, healthcare resource utilization (HCRU), and medical costs were assessed over a 2-year period. Percentages of individuals with comorbid conditions were summarized. Mean (SD) HCRU and total all-cause medical costs were presented per patient per year (PPPY). HCRU and medical costs PPPY were HCRU or medical costs 365 days before/after cohort entry divided by 2.

Results: 11,426 individuals with idiopathic hypersomnia and 31,214 with narcolepsy were included. Median ages were 45 and 43 years, respectively; approximately 65% of each cohort was female. Mean numbers of comorbid conditions across all categories were 15.4 (5.4) and 14.6 (5.7), respectively. Ill-defined conditions (95.6%, 94.4%), nervous system diseases (83.8%, 100.0%), and respiratory system diseases (83.6%, 79.1%) were most common broad clinical classification categories. Both cohorts experienced sleep apnea (62.8%, 52.1%), hypertension (45.7%, 42.9%), hyperlipidemia (42.2%, 38.4%), pain (66.4%, 66.0%), and mood disorders (41.9%, 43.3%). Mean all-cause outpatient visits PPPY among those with ≥1 visit were 28.2 (40.1) and 27.4 (40.6) for individuals with idiopathic hypersomnia or narcolepsy, respectively. Mean all-cause medical costs PPPY were $11,134 ($22,674) and $11,591 ($25,956) for individuals with idiopathic hypersomnia or narcolepsy.

Conclusion: Individuals with narcolepsy and idiopathic hypersomnia experience comorbid conditions which bear consequences for healthcare systems; these may be considered when evaluating overall health of individuals with either condition.