Adherence to Botulinumtoxin Treatment: A 2-year Retrospective Claims Database Analysis
David Simpson1, Jonathan Bouchard2, Simon Page2, Dean Spurden2, Seth Goldfarb2, Atul Patel3
1Mount Sinai School of Medicine, 2Ipsen, 3Kansas City Bone & Joint Clinic
Objective:
To describe treatment dynamics and persistence with botulinumtoxin (BoNT) over 2 years in a retrospective longitudinal study.
Background:
Understanding the use of BoNT in clinical practice is essential for improving clinical care. Real-world evidence on long-term persistence with BoNT therapy is limited.
Design/Methods:
This study assessed medical claims data from the IBM MarketScan database among patients with a first medical claim for BoNT (not product specific) between October 2016 and October 2019. The index date was the day of the first BoNT administration, and a 1-year washout period before this date was used to identify incident BoNT use. On-label indications were defined as those approved for abobotulinumtoxinA. Six cohorts were analyzed: 1, all patients; 2, all patients, excluding those with off-label indications at the index date; 3, all patients with on-label diagnosis during the study period; and 4, 5 and 6, all patients with diagnosis of stroke, migraine and bladder dysfunction, respectively, before the index date. The number of treatments in the 2-year follow-up period and persistency (120-day look forward from treatment date; 80th percentile value of days to next treatment) were evaluated.
Results:
Across all cohorts (cohort [n]: 1 [19 711], 2 [5741], 3 [3238], 4 [611], 5 [7778] and 6 [1791]), 18.8–46.9% of patients received only one injection. Proportions of patients receiving three to eight injections remained consistent, with 0.3–15.7% receiving eight injections. Mean number of treatments across cohorts was 2.1–4.7, and time between treatments (80th percentile) was 105–319 days.
Conclusions:
In this retrospective longitudinal real-world study, there was a large drop-off in the proportion of patients receiving BoNT treatment after first injection, with few patients receiving eight injections over 2 years in accordance with the standard treatment regimen. These data are limited in providing the underlying reasons for the drop-off; further research is warranted.