195. Healthcare resource utilization among adult patients with focal-onset seizures using cenobamate: a US database analysis

Abstract

Abstract Background Anti-seizure medication (ASM) polytherapy is a common treatment for individuals with uncontrolled epilepsy and is linked to higher health-care resource utilization (HCRU) than monotherapy. Cenobamate (XCOPRI®) is a novel ASM indicated for the treatment of focal-onset seizures (FOS) in adult patients in US. This study examines HCRU before and after cenobamate in US FOS patients. Aims & Objectives The aims of this study were to assess the use of cenobamate and other ASMs (monotherapy, stable polytherapy or changing tretment regimen), to compare HCRU parameters, e.g., hospitalizations, of pre-index vs. follow-up at 6 months treatment with cenobmate and to assess any correlation between number of ASMs and hospitalizations Method This retrospective observational study used the IQVIA PharMetrics Plus database, containing medical claims of approximately 140 million US enrolees. Adult cenobamate users with FOS were identified with the first cenobamate dispensation as index date (indexing period: April 1, 2020, to April 30, 2023). Eligible patients were required to have a pre-index 6-month baseline period, and 6-month follow-up. A treatment regimen evaluation (TRE) window of 90 days post-index was defined to evaluate patients on monotherapy (≥90 days prescription claims), stable polytherapy (overlapping ≥90 days’ supply of cenobamate and at least one ASM within +/- 30 days from cenobamate dispensing) or changing treatment regimen (all others). Results 1,132 patients were identified: 17 patients (1.5%) on monotherapy, 510 (45.1%) on stable polytherapy, and 605 (53.5%) on an changing treatment regimen. There was a decrease in the proportion of patients with at least one hospitalization from 21.9% (n= 248) in the baseline to 15.4% (n=174) in the follow-up period. In the monotherapy group, this decrease was from 17.7% (n=3) to 5.9% (n=1); in the stable polytherapy group from 22.8% (n=116) to 15.3% (n=78); in the changing treatment regimen group from 21.3% to 15.7%. There was an increase in the proportion of patients with at least one hospitalization as number of ASMs increased: 5.9% (n=1) on cenobamate monotherapy, 13.8% (n=33/240) for those with one additional ASM, 15.7% (n=29/185) for those with 2 additional ASMs, and 17.7% (n=15/85) for those with 3+ additional ASMs. Discussion & Conclusions The analysis demonstrated decreased hospitalisation in the 6 months after cenobamate initiation compared to baseline in monotherapy, stable polytherapy and changing treatment regimen groups.