Abstracts

Rationale: Vagus nerve stimulation (VNS) has been a FDA approved therapy for epilepsy for patients 12 and older and shown efficacy and safety in younger pediatric patients.  Mean total health care costs for children with epilepsy have been reported to be $6,379 compared to $1,032 for children without epilepsy.  Healthcare costs in treatment resistant patients with epilepsy are estimated to be much higher.  In addition, significant burden is associated with inpatient hospitalizations and emergency department (ED) visits for patients with epilepsy.  Methods: We performed a retrospective analysis utilizing Medicaid claims from an accountable care organization (ACO) to measure the intervention of VNS therapy in regards to unplanned healthcare utilization.  Thirteen unique patients were included who had VNS therapy who had at least 6 months of continuous enrollment in a managed Medicaid health plan.  Comparison with 12 months of data prior to after VNS implantation was performed.   Results: The data search identified 23 unique patients with VNS placement during January 2010 and September 2015.  Seven patients were excluded because they had less than 6 months of Medicaid enrollment either during the 12 months before or 12 months after their VNS placement and an additional 3 patients were excluded due to zero amounts on the claims which was likely due to data error for these patients.  Therefore, a total of 13 patients were included in this study (Table 1).  The range of ages for patients was 4 to 18 years of age.  The average age at time of implantation was 10.5 years of age.  About 38% of the study population were females (N=5) and 62% were males (N=8).On average, each patient had fewer unplanned inpatient visits per patient per month after they had VNS implantation (p-value = 0.03) (Table 2).  In regards to the number of ED visits, no statistical difference was noted following VNS implantation.  For neurology office visits, no statistical difference was noted following VNS implantation (Table 2).   Conclusions: Utilizing claims data, VNS implantation demonstrates a significant reduction in unplanned hospitalizations.  The reduction noted also will have a decreased financial impact as a result of decreased unplanned hospitalizations.  Further, decrease patient and caregiver burden is noted by decreased inpatient hospitalizations; which was another likely benefit noted following VNS implantation.   Funding: No