OBJECTIVE: To study associations between initiating eslicarbazepine acetate (ESL) vs. brivaracetam (BRV) after switching from generic antiseizure drugs (ASDs) and healthcare resource utilization (HCRU) and charges among patients with treated focal seizures (FS).

METHODS: This retrospective longitudinal cohort analysis used Symphony Health’s Integrated Dataverse claims during 4/1/2015−6/30/2018, with separate cohorts for switches to ESL and BRV following 1 generic ASD. Index date was the earliest claim for ESL or BRV. Patients had 1 generic ASD in the 12 months before index date, ≥1 medical claim with a FS diagnosis, and were ≥ 4 years old. Unit of analysis was the 90-day person-time-block. Baseline period was the block preceding index date, and patients had up to four blocks following. Inverse probability treatment weighted linear regression models with person fixed effects assessed pre-post and between-cohort changes in all-cause and FS-related HCRU and charges.

RESULTS: 282 patients initiated ESL (45.1 years, 57.5% female) and 139 BRV (42.7 years, 61.9% female). Levetiracetam was the most common prior ASD (ESL:44.3%, BRV:54.7%). Compared to baseline, ESL patients had reductions in all-cause (7.8 percentage point reduction (ppr); p=0.001) and FS-related (3.4 ppr; p = 0.017) inpatient hospitalization. Both cohorts experienced significant reductions in all-cause and FS-related outpatient visits. Compared to BRV, ESL patients had larger reductions in all-cause outpatient visits (9.0 ppr; p=0.008). Compared to baseline, ESL patients had reductions in all-cause (-$3,017; p<0.001) and FS-related (-$1,016; p=0.002) medical charges, non-FS related medical charges (-$2,001; p=0.001), and all-cause (-$1,544; p=0.013) and FS-related (-$851; p =0.004) outpatient charges. Compared to BRV patients, ESL patients had larger numerical reductions in all categories of all-cause and FS-related charges considered, except FS-related outpatient charges.

CONCLUSION: FS patients switching to ESL (vs.BRV) after one generic ASD had larger reductions in all-cause and FS-related HCRU and charges, except FS-related outpatient HCRU and charges.