0704 Impact of Sex and Race on Treatment of Narcolepsy: A Claims Database Analysis

Abstract Introduction Narcolepsy impacts patients across sex, race, and ethnicity. A retrospective analysis of claims data was conducted to characterize narcolepsy treatment patterns in men and women of different races and ethnicities. Methods Patients with exactly 1 valid narcolepsy type 1 (NT1) or 2 (NT2) diagnosis prior to 2023 whose claims were 100% observable in 2023 were identified in the Komodo Health claims database. Valid diagnosis was defined as ≥2 relevant ICD-10 codes 30 days apart. Patients were excluded for multiple separate NT1 or NT2 diagnoses or a single diagnosis supported by only 1 claim in 2023. The proportions of patients who received gold-standard narcolepsy treatment per 2021 American Academy of Sleep Medicine strong recommendations (ie, modafinil, pitolisant, solriamfetol, sodium oxybate, other oxybates, and armodafinil), oxybate treatment, or no treatments for excessive daytime sleepiness (EDS) in 2023 were calculated. Treatment patterns were stratified by race and ethnicity, and sex. Results The closed claims data set included 30,563 patients with a NT1 or NT2 diagnosis; 21,714 of these patients had race and ethnicity data and sex data available. Receipt of gold-standard narcolepsy treatments was lowest among Black or African American male patients (female, 42%; male, 41%) compared with Hispanic or Latino patients (female, 43%; male, 46%) and white patients (female, 47%; male, 51%). Black or African American female patients (female, 5%; male, 7%) were least likely to receive treatment with an oxybate compared with Hispanic or Latino patients (female, 9%; male, 6%) and white patients (female, 8%; male, 7%). Black or African American male patients (female, 35%; male 36%) were most likely to not receive an EDS treatment compared with Hispanic or Latino patients (female, 28%; male, 29%) and white patients (female, 21%; male, 22%). Conclusion These data demonstrate disparities in gold-standard narcolepsy treatment for Black or African American female and male patients compared with patients of other races and ethnicities. Despite being approved by the US Food and Drug Administration for narcolepsy, oxybate use was consistently low across race and ethnicity groups. Support (if any) Avadel Pharmaceuticals