Brian Seal

Will insomnia treatments produce overall cost savings to commercial managed-care plans? A predictive analysis in the United States

ABSTRACT Objective: Research indicates that insomnia may contribute significantly to healthcare costs; however, information on the effects of treatments on costs has not been thoroughly published. This study presents predictive models that forecast, from the perspective of commercial managed care, the effects of insomnia medications in reducing overall medical costs. The main objectives of this study were to predict the level of cost savings associated with insomnia treatments, illustrate the variation in outcomes given underlying model assumptions, and assist managed-care policy-makers with the evaluation of medications routinely administered for insomnia. Methods: Data on four primary-efficacy measures: wake after sleep onset (WASO), sleep efficiency (SE), sleep onset latency (SOL) and total sleep time (TST) were abstracted from published clinical trial data for eszopiclone, indiplon, low-dose trazodone, ramelteon, zaleplon, zolpidem and zolpidem extended-release. Change in per-patient per-year (PPPY) healthcare costs in a single claims database was calculated for subjects taking zolpidem, zaleplon and low-dose trazodone using generalized linear model (GLM) techniques, controlling for baseline demographics and baseline costs. Change in costs for emerging insomnia medications was forecasted by imputing efficacy values for these drugs into the regressions. Results: Using the accepted efficacy measure, WASO, zolpidem extended-release had the overall forecasted savings of –

Insomnia-related comorbidities and economic costs among a commercially insured population in the United States

1253 (CI: –

Factors Associated with Adherence Rates for Oral and Intravenous Anticancer Therapy in Commercially Insured Patients with Metastatic Colon Cancer

1404 to –

Disease burden of systemic light-chain amyloidosis: a systematic literature review

1404) PPPY compared to remaining treatments, whereas ramelteon cost an additional

Evaluation of Healthcare Interventions and Big Data: Review of Associated Data Issues

348 (–

Real-World Treatment Patterns and Health Care Resource Utilization in Relapsed or Refractory Multiple Myeloma: Evidence from a Cohort Review in France

1280 to

Use of Brentuximab Vedotin to Treat Hodgkin Lymphoma in a Private Sector Setting in Brazil

584) PPPY. In three out of four cost-efficacy models, zolpidem extended-release had higher mean forecasted PPPY savings. Conclusion: This study examined cost effects of existing and emerging insomnia medications using models integrating clinical literature and medical claims within a statistical framework. The use of a single database may limit generalizability and models only address a 1‑year period. Results suggest treatments can offer health plans direct cost savings, with amounts sensitive to variable and efficacy measures, potentially limited by those variables available in the claims database. Compared to other evaluated treatments, zolpidem extended-release produced consistently higher predicted cost savings.

Real-World Treatment Patterns in Relapsed or Refractory Multiple Myeloma: Evidence from a Medical Chart Review in the United Kingdom

ABSTRACT Objective: To describe the association between insomnia and comorbid conditions, and subsequent effects on total health costs and work productivity in a large managed-care setting. Methods: Administrative claims data from a large commercially insured population were reviewed for patients with a prescription claim for an insomnia medication or an insomnia-related medical diagnosis, between 1/1/2001 and 12/30/2003. A control group of patients having no insomnia-related medical or prescription claim was identified within this same time period. Propensity score matching methods were used to reduce observed biases between cohorts. Economic costs and comorbidities were evaluated using t-tests for bivariate comparisons, negative-binomial regression to assess the degree of comorbidity, Wilcoxon–Mann–Whitney test for cost outcomes and generalized linear models for multivariate cost comparisons. Results: Among both unmatched and matched cohorts, insomnia patients had statistically higher rates of depression, anxiety/phobia, stress, and head pain compared to the controls. After adjusting for patient covariates, insomnia patients had higher predicted healthcare and productivity costs than a cohort of matched control patients (

Global, Prospective, Non-interventional, Observational Study of Disease Presentation, Treatment Patterns, and Outcomes in Multiple Myeloma (MM) Patients (pts): The INSIGHT MM Study (NCT02761187)

4434 vs.

Newly Diagnosed Multiple Myeloma (NDMM): Effect of Age, Renal Insufficiency (RI), & Cardiovascular (CV) Disease (dz) on Overall Survival (OS) & Treatment (tx) Patterns Among Stem Cell Transplant (SCT)-Ineligible Patients (pts) in the United States (US)

3576; p < 0.001). Conclusion: Though identified patients were required to have enrollment in both medical and productivity databases, and the presence of insomnia could not be verified through medical records, these results suggest a significant link between insomnia and higher rates of comorbid conditions, healthcare expenditures and productivity losses. Payers and employers should consider insomnia as a factor in disease-related case-management initiatives.