To compare economic consequences, including healthcare resource utilization (HCRU) and costs, of associated morbidities (AMs) among commercially insured adult essential tremor (ET) patients taking multiple medications.

Patients with ET have been shown to have a higher number of comorbidities than non-ET patients, and this could lead to greater medication use. Previous research has demonstrated a high frequency of side effects due to pharmacotherapy in ET, yet data on the economic consequences are limited. Understanding the relationship between the medical complexity of ET patients, concurrent medication use and downstream economic consequences is crucial.  

Using the MarketScan database (1/1/2017- 6/30/2020), ET patients aged 22-64 (n=22,641) were stratified into subgroups taking 0, 1, and 2 of commonly prescribed ET drugs (propranolol, primidone, topiramate, gabapentin, and atenolol).

In the two years following index date, AMs increased with additional ET drugs: anxiety 31.9% vs. 40.6% vs. 44.0% (0, 1, 2 medications, respectively); depression 22.7% vs. 33.3% vs. 42.5% (0, 1, 2 medications, respectively); falls 3.4% vs. 5.0% vs. 8.6% (0, 1, 2 medications, respectively); substance abuse 5.4% vs. 8.6% vs. 12.1% (0, 1, 2 medications, respectively). Additionally, over the two-year period, HCRU and costs increased as patients took additional ET medications. Rates of all cause inpatient admissions and emergency room visits (costs) were 12.6% and 30.2% ($29,670) vs. 16.7% and 35.8% ($39,603) vs. 26.8% and 45.1% ($63,765) (0, 1, 2 ET medications, respectively).

AMs, HCRU and costs escalate with each additional ET medication. Effective ET treatments, both pharmacologic and non-pharmacologic, with fewer AMs may mitigate downstream HCRU and costs.