Objective: Characterize prominent medication utilization patterns among patients with Parkinson’s disease (PD).

Background: Multiple classes of medications, as monotherapy or polytherapy, are prescribed to treat PD symptoms. Current information about treatments over time is limited.

Method: US commercial and Medicare Advantage Part D (MAPD) enrollees ≥40 years old who had ≥2 PD diagnoses and initiated a PD treatment between 01May2015 and 30April2017 were identified. The date a new class of PD treatment began was the index date. Patients had continuous insurance coverage for 12 months before and 24 months after index. Cohorts were assigned by index treatment (amantadine (AMAN), anticholinergic (AC), catechol-O-methyl transferase inhibitor (COMT), carbidopa/levodopa (LEV), dopamine agonist (DA) or monoamine oxidase B inhibitor (MAOB)) and analyzed descriptively. A line of therapy (LOT) algorithm examined sequential regimens prescribed by PD medication class, length of and reason for end in patients’ first 3 LOTs during the post-index period.

Results: 3,097 patients were identified and assigned to LEV (n=2,428), DA (318), MAOB (187), AMAN (111), AC (41) and COMT (12) cohorts. Patients were mostly male (62.5%) with MAPD coverage (79.5%). LEV cohort was oldest (mean=75.4, SD=8.1). Total number of LOTs ranged from 1-15; 1,633 (52.7%) of patients had ≥2 LOTs and 845 (27.3%) had ≥3 LOTs. LEV was the most common treatment; 2,460 (79.4%) of patients’ first LOT included LEV, of whom 2,389 (77.1%) had LEV monotherapy in their first LOT and 1,843 (59.5%) were treated with only LEV monotherapy in post-index. Overall, 88.0% of patients with a first LOT, 70.1% with a second LOT and 69.7% with a third LOT had LEV monotherapy, DA monotherapy, or LEV/DA polytherapy. LEV had the longest mean duration (421 days) in the first LOT and LEV/DA had the longest mean durations across cohorts (range 279-600 days) in the second LOT. LEV (133-241 days) and LEV/DA (156-452 days) had the longest mean durations in the third LOT. Reasons for LOT end varied by LOT and cohort, but higher percentages of second and third LOTs endured until study end.

Conclusion: PD treatment patterns were stable for most patients; LEV was the most common PD treatment and had the highest percentage of patients with a single regimen. DA was also common as monotherapy and in LEV/DA combination. LEV and LEV/DA were prescribed for longer periods than other regimens.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/claims-data-analysis-of-parkinsons-disease-medication-utilization/