0705 Treatment Access for Narcolepsy Across Patient Demographic Characteristics: A Claims Database Analysis

Abstract Introduction Given the chronic nature of and diverse patient populations affected by narcolepsy type 1 (NT1) and type 2 (NT2), retrospective claims data were analyzed to characterize narcolepsy treatment access among different race/ethnicity and age groups. Methods Patients with exactly 1 valid NT1 or NT2 diagnosis (ie, ≥2 relevant ICD-10 codes 30 days apart) prior to 2023 and 100% observable claims in 2023 were identified in the Komodo Health claims database. Multiple separate NT1 or NT2 diagnoses or a single diagnosis with 1 claim in 2023 were exclusionary. Proportions of patients who received gold-standard narcolepsy treatment (ie, 2021 American Academy of Sleep Medicine strong recommendations [modafinil, pitolisant, solriamfetol, sodium oxybate], other oxybates, armodafinil), oxybate treatment, or no treatments for excessive daytime sleepiness (EDS) are presented by self-reported race (Black or African American [Black/AA] or white)/ethnicity (Hispanic or Latino [Hispanic/Latino]), and age. Results A total of 30,563 patients (NT1=15%; NT2=85%) with 1 NT1 or NT2 diagnosis were included in the closed data set. Race/ethnicity and age data were available for 22,010 patients (Black/AA, n=2685 [12.2%]; Hispanic/Latino, n=1871 [8.5%]; white, n=17,454 [79.3%]). Gold-standard narcolepsy treatments were received by 29% of patients aged 0-17y (Black/AA=23%; Hispanic/Latino=17%; white=40%), 48% aged 18-24y (Black/AA=38%; Hispanic/Latino=50%; white=51%), 52% aged 25-34y (Black/AA=43%; Hispanic/Latino=49%; white=54%), 49% aged 35-44y (Black/AA=47%; Hispanic/Latino=46%; white=49%), 49% aged 45-64y (Black/AA=41%; Hispanic/Latino=45%; white=51%), and 42% aged ≥65y (Black/AA=40%; Hispanic/Latino=39%; white=42%). Oxybate treatment was received by 11% of patients aged 0-17y (Black/AA=11%; Hispanic/Latino=7%; white=13%), 12% aged 18-24y (Black/AA=7%; Hispanic/Latino=14%; white=13%), 12% aged 25-34y (Black/AA=9%; Hispanic/Latino=9%; white=13%), 11% aged 35-44y (Black/AA=6%; Hispanic/Latino=10%; white=11%), 8% aged 45-64y (Black/AA=6%; Hispanic/Latino=7%; white=8%), and 3% aged ≥65y (Black/AA=2%; Hispanic/Latino=2%; white=3%). Patients who did not receive EDS treatment included 31% of patients aged 0-17y (Black/AA=28%; Hispanic/Latino=40%; white=29%), 22% aged 18-24y (Black/AA=30%; Hispanic/Latino=28%; white=18%), 20% aged 25-34y (Black/AA=34%; Hispanic/Latino=23%; white=17%), 18% aged 35-44y (Black/AA=29%; Hispanic/Latino=24%; white=16%), 22% aged 45-64y (Black/AA=37%; Hispanic/Latino=30%; white=19%), and 31% aged ≥65y (Black/AA=42%; Hispanic/Latino=36%; white=29%). Conclusion Across age groups, patients in racial/ethnic groups received fewer gold-standard narcolepsy treatments than white patients. Additionally, pediatric patients aged 0-17y and senior patients aged ≥65y were the least treated, highlighting potential gaps in care. Support (if any) Avadel Pharmaceuticals