Objective:

To assess patient characteristics, treatment patterns, and epilepsy/seizure-related healthcare resource utilization (HCRU) in patients with epilepsy who initiated brivaracetam (BRV) monotherapy.

Background:

BRV monotherapy real-world data are limited.

Design/Methods:

Retrospective analysis of de-identified data from Merative MarketScan of patients with epilepsy/seizure diagnoses (ICD-9 345.X/780.39; ICD-10 G40.X/R56.9) restricted to BRV monotherapy (defined as patients with a BRV pharmacy claim [date of first BRV claim during the identification period (01/01/2016–12/31/2020) = index date], antiseizure medications [ASMs] prescribed before BRV initiation discontinued <90 days after BRV initiation, and no claim for other ASM within 90 days after BRV initiation), with medical/pharmacy benefits for 12 months before and ≥90 days after index. HCRU (hospitalizations, intensive care unit [ICU], emergency department [ED], and outpatient [OP] neurology visits) were captured 12 months before (baseline) and after first BRV prescription (follow-up; ranging from 3-12 months).

Results:

594 patients (mean age 32.9 years; 56.9% female; 17.7%/79.3%/3.0% were <16/16-64/≥65 years of age) were identified. In the year before BRV initiation, 91.6% were taking ≥1 ASM (94.3%/90.9%/94.4% of patients aged <16/16-64/≥65 years); levetiracetam was the most frequent last ASM before BRV initiation (49.2%/49.0%/49.1%/52.9% of all/<16/16-64/≥65 years). 81.3% of patients had >365 days of follow-up (85.7%/80.9%/66.7% of patients aged <16/16-64/≥65 years). At 12-month follow-up, 31.5% of patients remained on BRV monotherapy (33.3%/30.6%/44.4% of patients aged <16/16-64/≥65 years). Median time to BRV discontinuation (Kaplan-Meier estimates) was 369 days (374 days/363 days for patients aged <16/16-64 years; not reached for patients ≥65 years). Epilepsy/seizure-related HCRU decreased for all/<16/16-64/≥65 groups from baseline to follow-up for hospitalizations: 15.5%/13.3%/16.1%/11.1% to 7.9%/8.6%/8.1%/0; ICU visits: 6.4%/2.9%/7.2%/5.6% to 2.5%/1.9%/2.8%/0; ED visits: 43.1%/44.8%/43.5%/22.2% to 20.5%/20.0%/21.2%/5.6%; and OP neurology visits: 70.9%/71.4%/70.7%/72.2% to 57.4%/59.0%/57.1%/55.6%.

Conclusions:

Approximately a third of patients in all age groups remained on BRV monotherapy at 12 months. For patients who initiated BRV monotherapy, epilepsy/seizure-related HCRU decreased from baseline to 12-month follow-up.