Economic aspects of insomnia medication treatment among Medicare beneficiaries

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STUDY OBJECTIVES: To examine economic aspects of insomnia and insomnia medication treatment among a nationally representative sample of older adult Medicare beneficiaries.

METHODS: Using a random 5% sample of Medicare administrative data (2006-2013), insomnia was defined using International Classification of Disease, Version 9, Clinical Modification diagnostic codes. Treatment was operationalized as one or more prescription fills for an US Food and Drug Administration (FDA)-approved insomnia medication following diagnosis, in previously untreated individuals. To evaluate the economic impact of insomnia treatment on healthcare utilization (HCU) and costs in the year following insomnia diagnosis, a difference-in-differences approach was implemented using generalized linear models.

RESULTS: A total of 23 079 beneficiaries with insomnia (M age = 71.7 years) were included. Of these, 5154 (22%) received one or more fills for an FDA-approved insomnia medication following insomnia diagnosis. For both treated and untreated individuals, HCU and costs increased during the 12 months prior to diagnosis. Insomnia treatment was associated with significantly increased emergency department visits and prescription fills in the year following insomnia diagnosis. After accounting for pre-diagnosis differences between groups, no significant differences in pre- to post-diagnosis costs were observed between treated and untreated individuals.

CONCLUSIONS: These results advance previous research into economics of insomnia disorder by evaluating the impact of medication treatment and highlighting important differences between treated and untreated individuals. Future studies should seek to understand why some individuals diagnosed with insomnia receive treatment but others do not, to identify clinically meaningful clusters of older adults with insomnia, and to explore the economic impact of insomnia and insomnia treatment among subgroups of individuals with insomnia, such as those with cardiovascular diseases, mood disorders, and neurodegenerative disease.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:43

Enthalten in:

Sleep - 43(2020), 1 vom: 13. Jan.

Sprache:

Englisch

Beteiligte Personen:

Wickwire, Emerson M [VerfasserIn]
Vadlamani, Aparna [VerfasserIn]
Tom, Sarah E [VerfasserIn]
Johnson, Abree M [VerfasserIn]
Scharf, Steven M [VerfasserIn]
Albrecht, Jennifer S [VerfasserIn]

Links:

Volltext

Themen:

Costs
Health economics
Healthcare utilization
Insomnia
Journal Article
Medicare
Older adults
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Sleep
Treatment

Anmerkungen:

Date Completed 26.05.2020

Date Revised 22.01.2021

published: Print

Citation Status MEDLINE

doi:

10.1093/sleep/zsz192

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM300282974