Abstract
Background and objectives: To compare the utilization and costs (total and out-of-pocket) of new-to-market neurologic medications with existing guideline-supported neurologic medications over time.
Results: We found that the utilization of most new-to-market medications was small (<20% in all but one condition), compared to existing, guideline-supported medications. The out-of-pocket and standardized total costs were substantially larger for new-to-market medications. The median (25th percentile, 75th percentile) out-of-pocket costs for a 30-day supply in 2019 were largest for edaravone ($712.8 ($59.8, $802.0)) and eculizumab ($91.1 ($3.0, $3,216.4)). For new-to-market medications, the distribution of out-of-pocket costs were highly variable and the trends over time were unpredictable compared to existing guideline-supported medications.
Discussion: Despite the increasing number of FDA-approved neurologic medications, utilization of newly approved medications in the privately insured population remains small. Given the high-costs and similar efficacy for most of the new medications, limited utilization may be appropriate. However, for new medications with greater efficacy, future studies are needed to determine if high costs are a barrier to utilization.
