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