Healthcare Resource Utilization (HCRU) in Patients with Epilepsy (PWE): A Comparison of Diazepam Nasal Spray (DNS) vs No Use
Edward Faught1, Leock Ngo2, Enrique Carrazana3, Adrian Rabinowicz4
1Emory Brain Health Center, 2Neurelis, Inc., 3John A. Burns School of Medicine, University of Hawaii, 4Neurelis, Inc.; Center for Molecular Biology and Biotechnology, Charles E. Schmidt College of Science, Florida Atlantic University
Objective:
Compare real-world HCRU among PWE, stratified by active DNS immediate-use seizure medication (ISM) prescription.
Background:
PWE taking antiseizure medications (ASMs) may experience seizure clusters, which can increase HCRU. DNS is approved for seizure clusters in PWE aged ≥2 years.
Design/Methods:
This retrospective, propensity-matched analysis utilized healthcare claims in the Real-World Data Insights database, collected January 1, 2020, to April 30, 2024. PWE were aged ≥2 years, had ≥1 epilepsy claim, ≥80% ASM adherence, and continuous data 6 months pre- and post-index date. Treatments and HCRU compared matched cohorts with/without DNS prescriptions.
Results:
Among 443,780 eligible patients, 10,782 had DNS prescriptions. Concomitant benzodiazepines (eg, clonazepam, clobazam) and cannabidiol were more common among patients with DNS (P<0.001). No patients reported concomitant rectal diazepam. Midazolam and gabapentin were more common in patients without DNS (P<0.001).
Epilepsy-related HCRU was generally lower with DNS, including proportions with inpatient and outpatient visits (both P<0.001). ER visits were similar (P=0.568). The DNS group had fewer mean inpatient visits, outpatient visits, and shorter stays (all P≤0.001). Numbers of patients with readmission <30 days were similar (P=0.568). Length of readmission stay (P<0.01) and per-patient average readmission (P<0.05) were lower with DNS.
All-cause HCRU was lower with DNS, including inpatient, outpatient, and ER visits (all P<0.001). Number of patients with readmission <30 days, length of readmission stay, and per-patient average readmission was lower with DNS (P<0.001).
Conclusions:
In this real-world database, PWE with DNS were more likely to receive concomitant medications indicative of refractory epilepsy. However, they had significantly fewer inpatient and outpatient visits and lower readmission rate vs a matched cohort, supporting the role of DNS in improved health outcomes that reduce patient, caregiver, and provider burden. Ongoing analyses will further analyze HCRU of PWE with DNS compared with other ISMs or no ISM.
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