Burden of Insomnia in Patients Undergoing Cancer Treatment: A US Retrospective Claims Database Analysis

Abstract: Almost half of patients with cancer have trouble sleeping and treatment can exacerbate these problems. Objectives: This study evaluated healthcare resource utilization (HCRU) and costs associated with insomnia in patients undergoing cancer treatment. Methods: This retrospective study used the IBM MarketScan commercial claims databases (Jan 2014-Dec 2019) to identify patients age ≥18 years with: (1) ≥1 ICD-9/ICD-10 codes for insomnia OR ≥2 prescriptions for zolpidem OR trazodone ≤150mg OR benzodiazepines; (2) ≥12 months of continuous enrollment pre-/post-index date (earliest diagnosis/medication fill date); (3) ≥2 ICD-9/ICD-10 codes for cancer; and (4) ≥1 claim for oncology treatment. Patients with sleep disorders other than insomnia were excluded. Patients (“insomnia cohort”) were 1:1 matched on age, sex and Elixhauser Comorbidity Index (ECI) score to those without insomnia (“control cohort”). Generalized linear models were used to compare adjusted HCRU and costs per patient per month (PPPM) during 12 months follow-up. Results: Each cohort included 7,132 patients (mean age 60.8 years, 69.5% female, 13.6 ECI score). In adjusted analyses and relative to controls, significantly more insomnia patients had ≥1 inpatient visit admission, longer inpatient stays, and higher mean outpatient visits (all p