Session Information
Session Title: AA 2021 Virtual Posters - General Rehabilitation
Session Time: None. Available on demand.
Disclosures: Alain Lamontagne, PhD: Ipsen biopharmaceutical (Products/Services: Yes) (Employment)
Objective: Botulinum toxin type A (BoNT-A) treatment is considered as first-line treatment for focal spasticity in adults (Simpson et al. 2016). We sought to use 2 US commercial claims databases to establish the proportion of patients with spasticity who receive BoNT-A treatment.
Design: To allow comparison of our results, two databases were interrogated for this research: the MarketScan database (IBM Watson) and the IQVIA APLD database.Setting : Database analysis.Participants : Eligible patients were defined as adults with at least one confirmed diagnosis of spasticity between 1-Jan-2010 and 31-Jun-2020 (MarketScan) or 1-Nov-2017 and 31-July-2020 (IQVIA), and with one diagnosis occurring in the last year (1-Jun-2019 to 31-Jun-2020 or 1-July-2019 to 31-July-2020). Patients with a recent diagnosis of spasticity (within 90 days of 31-Jun-20 or 31-July-20) were excluded. Spasticity was identified using ICD codes for spastic conditions (eg. monoplegia, diplegia, hemiplegia, contracture, etc.).
Interventions: None.
Main Outcome Measures: Proportions of patients receiving different interventions.
Results: In the MarketScan database, a cohort of 131,222 patients with spasticity was identified (mean age: 47; 60% female). In the most recent treatment visit, the most common treatment was physical therapy, which was administered to 88,793 patients (68%). 40,254 (31%) patients received myorelaxants, with 11,610 (9%) receiving baclofen and 9,421 (7%) receiving tizanidine. Only 5,299 (4.0%) were treated with BoNT-A. Comparable results were obtained by analysis of the IQVIA database: Of 1,095,402 patients identified with spasticity (mean age: 55; 53% female), only 32,346 (3%) were treated with BoNT-A.Conclusions: Data from 2 commercial claims databases indicate that, despite being a recommended first-line treatment, BoNT-A is only used in a small proportion of patients with spasticity. Further research into factors correlating with treatment decisions would be of value to better understand the patient journey in spasticity. 1. DM. Simpson et al. Neurology May 2016, 86 (19) 1818-1826
Level of Evidence: Level III
To cite this abstract in AMA style:
Lamontagne A, Lamontagne A, Darhi Y. Analysis of U.S. Commercial Claims to Understand Patient Treatment Pathways in Spasticity [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/analysis-of-u-s-commercial-claims-to-understand-patient-treatment-pathways-in-spasticity/. Accessed November 23, 2024.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/analysis-of-u-s-commercial-claims-to-understand-patient-treatment-pathways-in-spasticity/