• Article

Health care resource utilization and costs associated with restless legs syndrome among managed care enrollees treated with dopamine agonists

Purpose: This study assessed the direct economic burden of restless legs syndrome (RLS) among patients treated with dopamine agonists (DAs) using a large United States managed care database.

Design: Retrospective database analysis.

Methodology: Patients were required to have ?1 prescriptions for a DA (i.e., pergolide, pramipexole, ropinirole) between 1/1/2005 and 12/31/2007 (date of first DA, or “index”); continuous enrollment for ?6 months before and ?12 months after index; >1 diagnosis of RLS, before and after index; and no diagnosis of Parkinson’s disease. Study measures included annual all-cause and RLS-related costs by care setting (hospitalizations, emergency room, office, pharmacy, other, total) and treatment-pattern events (discontinuations, switches, adjunctive treatments, titrations).

Principal findings: A total of 7,796 patients met the inclusion criteria. About 70% of patients received ropinirole, and 30% received pramipexole at index. Approximately 91% had ?1 RLS-related office visits, and patients filled an average of 6.5 RLS-related prescriptions (DAs, gabapentin, carbidopa/levodopa) during the 1-year follow-up period. Mean (SD) all-cause health care costs were $11,485 ($21,362) per patient, mostly due to multiple medical conditions occurring with RLS. RLS-related costs were 6.7% of total all-cause costs (mean [SD] $774 [$1,504]), consisting of office visits (16%), pharmacy (63%), and other costs (20%). Approximately 58% had a treatment-pattern event suggesting a dopamine-related side effect. Opioids were the most commonly used adjunctive therapy (13% of patients).

Conclusion: We found relatively low costs associated with RLS treatment. These findings should encourage expanding the coverage of treatment to reduce the suffering and costs associated with RLS.

Citation

Meyers, J., Candrilli, S., Allen, R., Manjunath, R., & Calloway, M. (2012). Health care resource utilization and costs associated with restless legs syndrome among managed care enrollees treated with dopamine agonists. Managed Care, 21(10), 44-51.