Evidence map›Paper›PMID 34463922›Full record

ArticleAdvances in therapy2021

Changes in Healthcare Resource Use and Costs in Commercially Insured Insomnia Patients Initiating Suvorexant.

Hrishikesh P Kale, Zaina P Qureshi, Ruchit Shah, Rezaul Khandker, Marc Botteman, Weilin Meng, Ruth Benca

Open access · hybridAbstract read
In one paragraph

Article in Advances in therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 8 citations in OpenAlex.

  1. We know CBT-I works, now what?Faculty reviews · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Hrishikesh P KaleOPEN Health Evidence & Access, Bethesda, MD, USA.
Zaina P QureshiMerck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, USA. zaina.qureshi@merck.com.ORCID http://orcid.org/0000-0001-9605-3980
Ruchit ShahOPEN Health Evidence & Access, Bethesda, MD, USA.
Rezaul KhandkerMerck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, USA.
Marc BottemanOPEN Health Evidence & Access, Bethesda, MD, USA.
Weilin MengMerck & Co., Inc, 2000 Galloping Hill Rd, Kenilworth, NJ, USA.
Ruth BencaUniversity of California, Irvine, Irvine, CA, USA.
Access to Wholistic and Productive Living Institute · USMerck & Co., Inc., Rahway, NJ, USA (United States) · USUniversity of California, Irvine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInsomnia diagnosis has been associated with a significant clinical and economic burden on patients and healthcare systems. This study examined changes in healthcare resource use (HCRU) and costs in insomnia patients before and after initiation of suvorexant treatment.

methodsThis retrospective cohort study analyzed Optum Clinformatics Data Mart claims data (Jan 2010-Dec 2018). Patients with ≥ 2 insomnia diagnosis claims and ≥ 1 prescription for suvorexant were included. Prevalent and incident insomnia patients were analyzed separately. The change in the trends of HCRU and costs were examined for 12 months before and 12 months after suvorexant initiation. An interrupted time series (ITS) analysis was conducted to assess the level and slope changes. Subgroups of patients with mental health comorbidities were examined.

resultsThe study included 18,919 and 5939 patients in the prevalent and incident insomnia cohorts, respectively. For the prevalent cohort, mean (SD) age was 64.5 (14.1) years, 65% were female, 74% had Medicare Advantage coverage, and 61% had a Charlson comorbidity index score ≥ 1. Characteristics for the incident cohort were similar. The ITS results suggested that the trend for monthly total healthcare cost (THC) was increasing before suvorexant initiation (US$52.51 in the prevalent cohort, $74.93 in incident insomnia cohort), but, after suvorexant initiation, the monthly total cost showed a decreasing trend in both cohorts. The decrease in slope for THC after suvorexant initiation were $72.66 and $112.07 per month in the prevalent and incident cohorts, respectively. The monthly trends in HCRU rates also decreased. The subgroup analysis showed that decreases were 1.5-3 times greater for patients with mental health comorbidities.

conclusionsIn this real-world study, suvorexant initiation was associated with immediate and continued decreases in HCRU and costs in insomnia patients. Further research is needed to understand the effect of suvorexant initiation on direct medical costs as well as costs associated with lost productivity in other real-world settings.

Indexed as

Health Care CostsSleep Initiation and Maintenance DisordersAgedAzepinesDelivery of Health CareFemaleHumansMaleMedicareMiddle AgedRetrospective StudiesTriazolesUnited StatesAzepinessuvorexantTriazolesEconomic burdenHealthcare costsInsomniaReal-world evidenceResource useSuvorexantTime series

Identifiers

PMID34463922
PMCPMC8478735
OpenAlexW3197216329

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.