2016•NeurologyRequires access
Changes in Healthcare Resource Utilization Among Medicaid Patients with Lennox-Gastaut Syndrome Initiating Clobazam Treatment (P1.064)
John M. Stern, C. François, Augustina Ogbonnaya, Tasneem Lokhandwala, Pamela Landsman‐Blumberg, Amy Duhig, Vivienne Shen
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Abstract
Objective: The purpose of this study was to characterize healthcare resource utilization (HCRU) pre- and post-clobazam initiation among Medicaid patients with probable Lennox-Gastaut syndrome (LGS). Background: LGS is a severe form of childhood-onset epilepsy. Clobazam was approved in 2011 as an adjunctive treatment for seizures associated with LGS in patients ≥2 years. Methods: De-identified data from the MarketScan Multi-State Medicaid database (10/1/2010 through 3/31/2014) were used to identify patients with probable LGS (≥2 claims for generalized convulsive or non-convulsive epilepsy and ≥1 claim for developmental disorder or cognitive impairment) who initiated clobazam following the first claim suggestive of LGS. Seizure-related HCRU in the 12 months pre-clobazam initiation was compared with seizure-related HCRU in the 12 months post-clobazam initiation. Results: A total of 358 clobazam-treated patients with probable LGS and a minimum of 12-months follow-up post-treatment initiation were identified. Most patients were ≤12 years old (27.9[percnt], 0-5 y; 34.4[percnt], 6-12 y; mean age = 12.6 y) and had a filled prescription for at least 1 anti-epileptic drug (AED) prior to clobazam use [mean number of AEDs: 1.9±1.1 (SD)]. In the 12 months following clobazam initiation, significantly smaller proportions of patients were hospitalized (22.4[percnt] vs 33.0[percnt], P<.001) or visited the emergency room (29.3[percnt] vs 36.3[percnt], P=0.013) due to seizure-related events compared with the 12-month pre-clobazam period. Mean seizure-related inpatient (hospitalization, ER) and outpatient (office, laboratory) visits post-clobazam initiation also were significantly reduced. Conclusions: Among Medicaid enrollees with probable LGS, clobazam treatment resulted in fewer seizure-related inpatient and outpatient services compared with an analogous period before clobazam initiation. Funded by Lundbeck, LLC