MIAMI—Patients younger than 65 have a higher polypharmacy burden in the management of Parkinson’s disease symptoms, compared with patients age 65 and older, according to research presented at the First Pan American Parkinson’s Disease and Movement Disorders Congress.
A claims database analysis found that a majority of patients were on levodopa-based therapy, and patients on levodopa-based therapy remained on their current regimens longer, compared with patients on non–levodopa-based regimens, “suggesting that levodopa remains the cornerstone of care across all observed therapies,” the researchers said.
To assess patterns of antiparkinson drug use and treatment changes in the United States, Alexander Niyazov, PharmD, MPH, Associate Director of Health Economics and Outcomes Research at Acorda Therapeutics in Ardsley, New York, and colleagues analyzed data from the Truven Health MarketScan retrospective claims database from the first quarter of 2010 to the fourth quarter of 2014.
Alexander Niyazov, PharmD, MPH
The study population included people who were diagnosed with Parkinson’s disease and who had filled at least two prescriptions for antiparkinson drugs, with the second fill occurring within 30 days after the previous supply’s end. Patients were included in the study until their insurance coverage ended or until their data cutoff.
The investigators included 76,602 patients in the study, with an average study period of 25.3 months. At the index date, patients’ mean age was 71.5, 30.7% were younger than 65, 59.4% were male, and 40.7% were treated by a neurologist.
Overall, 57.9% of patients remained on their first observed therapy, while 42.1% proceeded to a second therapy. Of those with a second therapy, 37.6% of patients proceeded to a third therapy. “The high rate of therapy changes highlights unmet needs and opportunities for improving the management of Parkinson’s disease,” the researchers said.
Initially, 72.7% of patients received monotherapy, and levodopa was the most common monotherapy (51.3%). Combination therapies were more common among patients who were younger than 65 and who were being treated by a neurologist.
Patients treated with a levodopa-based therapy remained on their current regimens for a median of 11.1 months, whereas patients receiving non–levodopa-based therapies remained on their current regimens for a median of 6.0 months.
Limitations of the study include potential inaccuracies and incompleteness of claims coding, and the fact that filled prescriptions may not include all drugs prescribed or represent the patient’s drug utilization. The study was supported by Acorda Therapeutics.
—Jake Remaly
