Abstract Details

Title Pediatric Focal Epilepsy: Patient Characteristics, Treatment Choices, Healthcare Resource Use and Costs by Developmental Delay and Behavioral Disorders Comorbidity Subgroups: A US Claims Database Analysis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-035

Objective To describe characteristics of pediatric patients with focal epilepsy by comorbidity subgroup, including treatment choice and healthcare costs.

Background Identifying differences between pediatric epilepsy patients should inform treatment choice and support more personalized medicine.

Design/Methods Retrospective study (US Truven Health MarketScan Commercial Claims database [01-Jan-2011 to 30-Sep-2015]) including pediatric patients (4-16 years) with ≥2 epilepsy diagnoses (≥1 with focal seizures). Index date was defined as the first antiepileptic drug (AED) claim date with continuous medical/pharmacy enrollment for ≥12 months pre-index (baseline period) and post-index date. Comorbidity subgroups were developmental delay (DD) and behavioral disorders (BD) identified by relevant diagnosis; patients with both were in the DD subgroup. Baseline characteristics (age, gender, comorbidities, AEDs, healthcare resource use and costs) are reported.

Results

10,092 patients were included (mean age [SD], 10.5 [3.5] years; 54.9% male); DD (n=3450, 34.2%; 9.9 years, 60.0% male), BD (n=1487, 14.7%; 11.6 years, 55.5% male). Serious comorbidities in the DD/BD subgroups included congenital malformation (32.9%, 10.4%), cerebrovascular diseases (29.4%, 15.2%), cerebral palsy (28.8%, 7.3%), and cardiovascular disorders (16.0%, 11.2%). The most common AEDs for DD/BD subgroups and other patients were levetiracetam (29.0%, 29.6%, 36.1%), oxcarbazepine (18.9%, 25.8%, 28.3%), valproate (14.4%, 10.2%, 7.7%), and lamotrigine (12.7%, 15.4%, 11.5%). Baseline characteristics differed between DD and BD subgroups and other patients in age; gender; number of AEDs (≥2 AEDs, 39.1%, 24.9%, 20.2%); mean number of all-cause inpatient (2.8, 1.5, 0.7), outpatient (40.1, 17.7, 11.6), and pharmacy (22.4, 15.9, 10.9) visits; and median total all-cause healthcare costs ($19,205, $8816, $5733).

Conclusions Nearly half of pediatric patients with focal epilepsy present with DD/BD—subgroups characterized by high comorbidity burden—and were associated with differences in age, gender, healthcare costs, and prescribed AEDs. Further research is needed to assess outcome differences by AED and create treatment plans specific to comorbidity groups.

Authors/Disclosures
PRESENTER	No disclosure on file
Simon Borghs	No disclosure on file
	No disclosure on file
	No disclosure on file
Nadia Foskett	No disclosure on file

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