MINNEAPOLIS—Narcolepsy entails a significant burden of illness and is associated with a substantial degree of medical comorbidity and health care burden, according to researchers reporting at the 28th Annual Meeting of the Associated Professional Sleep Societies. Drawing information from the Burden of Narcolepsy Disease (BOND) Database, researchers examined patterns of narcolepsy-associated burden of illness in men versus women and, separately, comorbidity and health care utilization across all adult age categories.
Women Experience a Greater Burden Than Men
A comprehensive, nationwide study found a significant burden of illness among men and women with narcolepsy, although a greater comorbidity burden was observed in women, compared with men. In addition, health care utilization and health plan costs were also higher among women.
Jed Black, MD, Consulting Associate Professor at Stanford University in California, and colleagues used five years of medical claims data to assess a population of 9,312 patients with narcolepsy and 46,559 matched controls. Both males and females with narcolepsy had a significantly greater number of comorbid diagnoses, compared with controls. Regardless of narcolepsy status, odds ratios for almost all comorbidity categories were higher in women, compared with men. This finding was even more pronounced within the narcolepsy cohort. Health care service utilization rates and drug costs were significantly higher among narcolepsy patients versus controls for both men and women, although utilization of services was higher in female versus male patients.
Age-Related Burden of Illness Using the same medical claims database and the same patient and control cohorts, Dr. Black and colleagues also examined the burden of narcolepsy across age groups. The greatest prevalence of comorbidities was seen among persons between ages 45 and 54, although the youngest cohort (ages 18 to 24) evidenced the greatest prevalence of anxiety and mood disorders. The percentage excess chronic illness burden (narcolepsy versus controls) was greatest in the 18 to 24 age group (111%), followed by the 25 to 34 age group (94%) and the 35 to 44 age group (85%). Among patients with narcolepsy, diagnoses of anxiety and mood disorders declined with increasing age.
For all age groups, mean annual utilization rates for health care services and non-narcolepsy drugs were approximately doubled, compared with controls, with the greatest excess noted among younger patients with narcolepsy versus controls.
—Glenn S. Williams