Epilepsy, a debilitating neurological condition characterized by recurrent seizures, is estimated to affect more than two million people in the United States—imparting a socioeconomic burden on patients and their families, healthcare institutions, and on society. Epilepsy pharmacotherapy comprises numerous established first-, second-, and third-generation antiepileptic drugs (AEDs) that are prescribed to prevent the recurrence of seizures and, in turn, preserve epilepsy patients’ quality of life. Polypharmacy is common for epilepsy patients who do not respond to monotherapy, and an estimated 20-30% of drug-treated epilepsy patients continue to experience seizures despite treatment with adjunctive AED regimens. Using national patient-level claims data, this report analyzes physicians’ prescribing patterns by exploring the use of key therapies in newly diagnosed and recently treated epilepsy patients. The report provides a quantitative line of therapy analysis in newly diagnosed patients, including patient share for key therapies, concomitant drug use, and the timing of progression between lines of therapy. Among recently treated patients, the report quantifies a drug’s source of business compared with its competitors and offers an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by therapy.

Questions Answered in This Report:

  • Newly diagnosed patients: Approximately 40% of epilepsy patients begin treatment with a key therapy within a year of their initial diagnosis. What percentage of these patients progress to a second- or third-line drug within the first year? Which products capture the most patient share in the first, second, and third lines of treatment? How often is combination therapy used in each line of therapy?

  • Recently treated patients: Second-generation AEDs capture the greatest percentage of recently treated patient prescriptions. Which specific drugs hold the highest patient share for recently treated epilepsy patients? When do patients progress from one therapy to the next in epilepsy, and how does this pattern differ between key drugs? Are most patients who are recently treated with each key brand coming through new (adds/switches) or continuing business?

  • Pathways to key therapies: Longitudinal claims data reveal use patterns of key therapies among recently treated epilepsy patients over time. Which drug classes and therapies have experienced market growth or decline over the key therapy periods studied? To what extent are key therapies prescribed concomitantly to recently treated patients, and with what other drugs are they prescribed to patients as adjuncts?

Scope:

Primary patient-level data: Quantitative findings from our analysis of data covering approximately 40 million lives. The most representative sample of U.S. treatment practice for Medicare and commercially insured patients. This report is delivered as a key findings slide deck and a dashboard that can be accessed using the Internet with claims that are less than six months old at the time of publication.

Patient Sample:

Patients who are continuously enrolled for the complete two-year study period must meet the following condition: at least one claim with a diagnosis code for epilepsy (International Classification of Diseases, Ninth Revision [ICD-9] diagnostic codes 345.0, 345.1, 345.4, 345.5, 345.8, 345.9) during the study period.

Quantified lines of therapy analysis showing exact share of each agent in each line of therapy, including rate of progression between lines and length of time patients are on each line.

Newly Diagnosed Patients:

- Patient share by drug class and key products across three lines of therapy, within one year of diagnosis.

- Patient flowcharts through one year of treatment for all first-line products, including progression rates and add/switch behavior.

- Polypharmacy and key concomitant therapies by line of therapy.

- Quarterly trending of patient share by line of therapy.

Recently Treated Patients:

- Quarterly snapshot of patient share by drug class and key products.

- Pathway to key therapy flowcharts tracking the preceding therapy patterns for all key therapies, including add/switch behavior.

- Brand source of business including share for continuing, new (switches/adds), and new (initial therapy) business.

- Polypharmacy and key concomitant therapies.

- Drug persistence and compliance.

- Quarterly trending of patient share for all key therapies.


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