0703 Impact of Economic Status Across Race and Ethnicity on Narcolepsy Treatment Access: A Claims Database Analysis

Abstract Introduction Narcolepsy type 1 (NT1) and type 2 (NT2) affect patients of diverse backgrounds. Methods The Komodo Health claims database was used to identify 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. Multiple separate NT1 or NT2 diagnoses or a single diagnosis with 1 claim in 2023 was 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, and armodafinil), oxybate treatment, or no treatments for excessive daytime sleepiness (EDS) in 2023 were calculated by self-reported race and ethnicity, and national income tercile. Results The closed data set included 30,563 patients with a single NT1 or NT2 diagnosis (NT1, 15%; NT2, 85%); of these, 16,389 patients had race and ethnicity data and income data available. Gold-standard narcolepsy treatments were received by 41% of Black/African American, 44% of Hispanic/Latino, and 48% of white patients. Oxybate treatment was received by 5% of Black/African American, 8% of Hispanic/Latino, and 8% of white patients. EDS treatments were not received by 35% of Black/African American, 28% of Hispanic/Latino, or 21% of white patients. The greatest proportions of patients who received gold-standard narcolepsy treatments were in the upper income tercile (lower, middle, upper terciles, respectively: Black/African American, 40%, 44%, 49%; Hispanic/Latino, 41%, 47%, 53%; white, 45%, 50%, 53%). The greatest proportions of patients who received oxybate treatment were in the upper income tercile (lower, middle, upper terciles, respectively: Black/African American, 4%, 7%, 8%; Hispanic/Latino, 7%, 8%, 10%; white, 6%, 7%, 11%). The lowest income tercile had the greatest proportion of patients not receiving EDS treatments (lower, middle, upper terciles, respectively: Black/African American, 39%, 36%, 30%; Hispanic/Latino, 31%, 28%, 22%; white, 23%, 20%, 19%). Conclusion These results reflect disparities in narcolepsy treatment, as patients in racial and ethnic groups consistently did not receive gold-standard treatments, regardless of income level. Support (if any) Avadel Pharmaceuticals