Abstract Details

Title The Trend in Botulinum Toxin Injection among Medicare Neurology Providers in the United States from 2012 to 2016

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-023

Objective

This study aimed to identify the trend in Botulinum Toxin (BTX) injection in Medicare beneficiaries referred to Neurologists over a five-year period.

Background

BTX has been used for medical purposes since the 1970s. Over the last decade, the indication of BTX injection has been expanded for cosmetic and non-cosmetic applications. Blepharospasm, hemifacial spasm, sialorrhea, dystonias, and spasticity are the most common neurological conditions managed by BTX injection.

Design/Methods

This is a retrospective study of publicly available Medicare providers utilization services and payment data from 2012 to 2016. The following Healthcare Common Procedure Coding System (HCPCS) codes submitted by Neurology providers were evaluated; The type of toxin injected (J0585, J0586, J0587, J0588) and anatomical distribution of injections (64611, salivary glands injection; 64612, 64615, injection of facial muscles; 64616, cervical muscles; 64642, 64643, 64644, 64645, upper or lower limb). IBM SPSS statistical software 25.0 was used for data analysis.

Results

Evaluation of average annual 134,086 physician/ HCPCSs submitted by neurologists revealed a total of 12,070,973 BTX injection services for 27,235 beneficiaries in 2012 (Onabotulinum Toxin A 94.8%, Abobotulinum Toxin A 1.2%, Rimabotulinum Toxin B 1.0%, and Incobotulinum Toxin A 3.0%). There was a 69.9% increase in the number of toxin injection services to 20,506,826 services for 42,747 beneficiaries in 2016 (with the same distribution of toxin type).

The number of bilateral facial injections has dramatically increased (69.6%) from 28,684 services in 2014 to 48,654 services in 2016, while the growth rate of other services including unilateral face injection (10.9%), cervical injections (14.0%), and limb injections (16.5%) was lower in the same period of time.

Conclusions

Onabotulinum Toxin A is the leading neurotoxin used by Medicare Neurologists. Similar to rapidly expanding BTX application for cosmetic use in the US, there is a growing trend for therapeutic BTX injection in neurological conditions, especially those involving facial muscles.

Authors/Disclosures
Shahnaz Miri, MD (Wilmer Eye Institute, Johns Hopkins University) PRESENTER	Dr. Miri has received intellectual property interests from a discovery or technology relating to health care.
Laxman Bahroo, DO, FAAN (Medstar Georgetown University Hospital)	Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acorda. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurocrine. Dr. Bahroo has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Supernus. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ipsen. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amneal. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acadia. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Revance. Dr. Bahroo has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Bahroo has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Abbvie. Dr. Bahroo has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Acorda. Dr. Bahroo has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Amneal. Dr. Bahroo has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Supernus. Dr. Bahroo has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Neurocrine. Dr. Bahroo has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Bahroo has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Lundbeck. Dr. Bahroo has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Merz.

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