Healthcare burden of narcolepsy in Japan: A retrospective analysis of health insurance claims from the Japan Medical Data Center.

Background: Narcolepsy is a chronic disorder that requires lifelong management; however, few studies have evaluated disease burden of narcolepsy. We estimated the healthcare burden of narcolepsy in Japan using data from the Japan Medical Data Center health insurance claims database.

Methods: This was a retrospective analysis of clinical burden, healthcare resource utilization, and costs among incident narcolepsy cases and matched controls identified between January 1, 2014 and December 31, 2019.

Results: Of the 1317 incident cases; 889 (with 1778 controls) were analyzed for healthcare burden, 626 (with 1252 controls) for clinical journey, and 439 (no controls) for treatment patterns. The most common baseline comorbidity was non-narcolepsy sleep disorder (41.6 % cases vs 3.0 % controls), including insomnia (28.5 % vs 2.6 %) and sleep apnea (10.8 % vs 0.3 %; both p < 0.001). The most common nonsleep disorder comorbidities were depression (35.0 % vs 2.6 %), anxiety (30.4 % vs 2.7 %), and headache/migraine (18.1 % vs 5.5 %; all p < 0.001). Compared to controls, narcolepsy cases had more prescription claims in the year following index date (82.8 % vs 9.5 %; p < 0.001), higher rates of outpatient (2291.8 vs 674.9 visits/100 person-years; p < 0.001) and inpatient claims (56.8 vs 5.1/100 person-years; p < 0.001), and longer hospital stays (mean 2.9 vs 0.5 days; p < 0.001). Similarly, median HCRU costs were higher in cases than controls (total annual healthcare costs, $2531 vs $266; community pharmacy claims, $826 vs $47 per person; and outpatient claim costs, $1053 vs $188 per person year).

Conclusions: Narcolepsy carries a substantial comorbidity burden, a high rate of medication prescribing, and high healthcare resource use in Japan.