Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine

**Background:** Huntington’s disease (HD) is a multifaceted neurodegenerative disorder characterized by involuntary movements, specifically chorea, as well as behavioral and psychiatric disturbance, and cognitive dysfunction. Tetrabenazine was the first approved treatment for chorea, although tolera...

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Main Authors: Victor W. Sung, Sanjay K. Gandhi, Victor Abler, Brian Davis, Debra E. Irwin, Karen E. Anderson, Ravi G. Iyer
Format: Article
Language:English
Published: Columbia Data Analytics, LLC 2018-01-01
Series:Journal of Health Economics and Outcomes Research
Online Access:https://doi.org/10.36469/9779
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author Victor W. Sung
Sanjay K. Gandhi
Victor Abler
Brian Davis
Debra E. Irwin
Karen E. Anderson
Ravi G. Iyer
author_facet Victor W. Sung
Sanjay K. Gandhi
Victor Abler
Brian Davis
Debra E. Irwin
Karen E. Anderson
Ravi G. Iyer
author_sort Victor W. Sung
collection DOAJ
description **Background:** Huntington’s disease (HD) is a multifaceted neurodegenerative disorder characterized by involuntary movements, specifically chorea, as well as behavioral and psychiatric disturbance, and cognitive dysfunction. Tetrabenazine was the first approved treatment for chorea, although tolerability concerns exist. **Objectives:** To characterize demographic and clinical characteristics of HD patients with chorea based on tetrabenazine use and examine treatment persistence with tetrabenazine in a real-world setting. **Methods:** Patients with a claim for HD-associated chorea (ICD-9-CM code 333.4) between 1/1/08 and 9/30/15 were selected from the MarketScan® Commercial and Medicare Supplemental databases. The first diagnosis date during the study period was considered the index date, with ≥6 months of continuous medical and prescription coverage before and after the index date. Treatment persistence was defined as the number of days from initiation to discontinuation or end of follow-up period. Discontinuation was defined as a gap in therapy of ≥60 days. **Results:** 1644 patients met selection criteria (mean age ± standard deviation: 54.5 ± 15.5), of which 151 (9.2%) were treated with tetrabenazine during the study period. The average (median) daily dose of tetrabenazine during the treatment period was 45.5 (42.3) mg/day. A total of 41.8% (59/141) of HD patients who initiated tetrabenazine experienced a ≥60-day gap in tetrabenazine therapy, with a median time to discontinuation of 293.5 days. During the 6-month post-index period after HD diagnosis, HD patients incurred higher all-cause healthcare costs ($20 204) vs the 6-month pre-index period ($6057), driven by higher hospitalization and pharmacy costs. **Conclusions:** A small percentage of HD patients with chorea were treated with tetrabenazine and discontinuation rates were high among those receiving treatment, with a median time to discontinuation of 9 months.
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spelling doaj-art-5561f5b9136949d58a9f72be8f2285812025-02-10T16:12:46ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362018-01-0161Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on TetrabenazineVictor W. SungSanjay K. GandhiVictor AblerBrian DavisDebra E. IrwinKaren E. AndersonRavi G. Iyer**Background:** Huntington’s disease (HD) is a multifaceted neurodegenerative disorder characterized by involuntary movements, specifically chorea, as well as behavioral and psychiatric disturbance, and cognitive dysfunction. Tetrabenazine was the first approved treatment for chorea, although tolerability concerns exist. **Objectives:** To characterize demographic and clinical characteristics of HD patients with chorea based on tetrabenazine use and examine treatment persistence with tetrabenazine in a real-world setting. **Methods:** Patients with a claim for HD-associated chorea (ICD-9-CM code 333.4) between 1/1/08 and 9/30/15 were selected from the MarketScan® Commercial and Medicare Supplemental databases. The first diagnosis date during the study period was considered the index date, with ≥6 months of continuous medical and prescription coverage before and after the index date. Treatment persistence was defined as the number of days from initiation to discontinuation or end of follow-up period. Discontinuation was defined as a gap in therapy of ≥60 days. **Results:** 1644 patients met selection criteria (mean age ± standard deviation: 54.5 ± 15.5), of which 151 (9.2%) were treated with tetrabenazine during the study period. The average (median) daily dose of tetrabenazine during the treatment period was 45.5 (42.3) mg/day. A total of 41.8% (59/141) of HD patients who initiated tetrabenazine experienced a ≥60-day gap in tetrabenazine therapy, with a median time to discontinuation of 293.5 days. During the 6-month post-index period after HD diagnosis, HD patients incurred higher all-cause healthcare costs ($20 204) vs the 6-month pre-index period ($6057), driven by higher hospitalization and pharmacy costs. **Conclusions:** A small percentage of HD patients with chorea were treated with tetrabenazine and discontinuation rates were high among those receiving treatment, with a median time to discontinuation of 9 months.https://doi.org/10.36469/9779
spellingShingle Victor W. Sung
Sanjay K. Gandhi
Victor Abler
Brian Davis
Debra E. Irwin
Karen E. Anderson
Ravi G. Iyer
Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine
Journal of Health Economics and Outcomes Research
title Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine
title_full Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine
title_fullStr Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine
title_full_unstemmed Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine
title_short Retrospective Analysis of Healthcare Resource Use, Treatment Patterns, and Treatment-related Events in Patients with Huntington’s Disease–associated Chorea Initiated on Tetrabenazine
title_sort retrospective analysis of healthcare resource use treatment patterns and treatment related events in patients with huntington s disease associated chorea initiated on tetrabenazine
url https://doi.org/10.36469/9779
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