Objective: Understand healthcare resource use (HCU) and costs for commercially insured patients with epilepsy in United States treated with brivaracetam (BRV) in the 12 months pre- and post-treatment initiation.

Methods: Retrospective cohort analysis using IBM MarketScan Commercial Claims and Encounters Database. Patients ≥18 years with baseline epilepsy/seizure diagnosis and continuous medical and pharmacy benefit for 12 months pre- and post-BRV initiation between March 1, 2016 and September 30, 2018 were included. Patients with BRV use during baseline period (12 months pre-BRV initiation) were excluded.

Results: 479 commercially insured BRV patients were identified (mean age 37.5 years; 60.1% female). Most common seizure type was focal (36.5%). During baseline period, 67.4% of patients received ≥2 antiseizure medications. From 6 months to 1 month pre-BRV initiation, the number of patients with epilepsy-related inpatient or outpatient HCU increased (16 to 32 and 158 to 363, respectively), suggesting uncontrolled epilepsy. Mean total epilepsy-related costs increased 45% during 12-month follow-up period versus 12-month baseline period ($40,212 versus $27,671, respectively), which was mainly driven by pharmacy cost. Within 1 month post-BRV initiation, mean total epilepsy-related medical costs decreased ($2,030 versus $3,122 in the month pre‑BRV initiation), but increased 15% during 12-month follow-up period versus 12-month baseline period ($21,269 versus $18,472, respectively). Mean monthly epilepsy-related medical costs were lower during 12-month follow-up period versus 6 months pre-BRV initiation ($1,772 versus $2,078, respectively). Within 1 month post-BRV initiation, the number of patients with epilepsy-related inpatient or outpatient HCU declined by 50.0% (32 to 16) and 37.5% (363 to 227), respectively, versus the month pre-BRV initiation. This study was not designed to detect statistically significant differences pre- and post-BRV initiation.

Conclusions: In a seizure/epilepsy patient population newly starting BRV, annual epilepsy-related costs increased but epilepsy-related HCU and medical costs were reduced in the period immediately post-BRV initiation.

Funding: UCB Pharma-funded.