Clinical and Economic Correlates of Pharmacotherapy in Patients with Essential Tremor

Tremor Other Hyperkinet Mov (N Y). 2024 Dec 17:14:60. doi: 10.5334/tohm.973. eCollection 2024.

Abstract

Background: Essential tremor (ET) is among the most common movement disorders, yet there are few treatment options. Medications have limited efficacy and adverse effects; thus, patients often discontinue pharmacotherapy or take several medications in combination. We evaluated the economic correlates (healthcare resource utilization [HCRU] and costs) and comorbidities among adults with and without ET and among subgroups of patients with ET prescribed 0 to ≥3 ET medications.

Method: This was a retrospective cohort study using claims data from the Merative Market Scan Research Databases (1/1/2017-1/31/2022). Patients were categorized as commercially insured (22-<65 years) or Medicare (≥65 years) and stratified into 3 subgroups: patients with untreated ET, patients with treated ET, and non-ET patients. The index date was the date of first ET diagnosis or a random date (non-ET patients); post-index follow-up was 24 months.

Results: There were 32,984 ET patients (n = 22,641 commercial; n = 10,343 Medicare) and 7,588,080 non-ET patients (n = 7,158,471 commercial; n = 429,609 Medicare). ET patients in both commercial and Medicare populations filled a numerically greater number of unique medications, had a higher numerical prevalence of comorbidities (ie, anxiety, depression, falls), and had numerically greater HCRU and costs than non-ET patients. Most of these numerical trends increased commensurately with increasing number of ET medications.

Conclusions: Compared to non-ET patients, ET patients have higher healthcare costs and utilization, which positively correlated with the number of ET medications. ET patients often have numerically more comorbidities compared to non-ET patients. This analysis demonstrates the medical complexity of ET patients and calls attention to the need for additional therapeutic options.

Keywords: clinical burden; economic burden; essential tremor; neurologic disorders; pharmacotherapy burden; real-world evidence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Essential Tremor* / drug therapy
  • Essential Tremor* / economics
  • Female
  • Health Care Costs / statistics & numerical data
  • Humans
  • Male
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Retrospective Studies
  • United States
  • Young Adult