Real-World Treatment Switch Rates, and Healthcare Costs of Botulinum Toxin Type A Among Patients with Cervical Dystonia in the USA: A Retrospective Claims Analysis.

INTRODUCTION

Real-world evidence on comparative treatment patterns and cost is limited for botulinum toxin type A (BoNTA) treatments for cervical dystonia (CD). This study aims to evaluate treatment switch rates, healthcare resource utilization (HCRU), and healthcare costs among patients with cervical dystonia initiating BoNTAs in the USA.

METHODS

This retrospective study analyzed real-world data from Optum's de-identified Clinformatics® Data Mart Database between January 1, 2016 and December 31, 2024. Eligible adults with CD with ≥ 12-month continuous enrollment before and after the first BoNTA treatment were included. The first date of BoNTA administration after the first CD identification in the study period was assigned as the index date. Treatment switch rates were assessed during the first 12 months following BoNTA initiation and at anytime before the study period end. Annual healthcare resource use and healthcare costs were also assessed in the 12 months following treatment initiation.

RESULTS

Overall, 1756 adults with CD initiated therapy on BoNTAs. OnabotulinumtoxinA (onabotA) (88.6%; 1555/1756) was utilized most, followed by incobotulinumtoxinA (incobotA) (9.3%; 163/1756), and abobotulinumtoxinA (2.2%; 38/1756). As a result of the small sample size of abobotulinumtoxinA, comparative analysis was focused on onabotA and incobotA. Treatment switch was comparable between onabotA and incobotA during 12-month follow-up. Treatment switch at anytime before study period end was lower for onabotA versus incobotA initiators (2.6% vs. 6.8%; P = 0.007). Annual HCRU and costs were comparable between onabotA and incobotA, except CD-related costs and toxin-related costs were lower for onabotA.

CONCLUSION

Patients with CD who initiated therapy on onabotA had comparable switch rates at 12 months but were less likely to switch to another BoNTA at anytime and had lower or comparable costs to incobotA.