Tardive Dyskinesia: Epidemiological Trends in US Populations Based on Cross-Sectional Analysis of Retrospective Claims Data

Abstract: Background: Tardive dyskinesia (TD), an iatrogenic movement disorder associated with antipsychotic agent (AP) use, is predicted to increase in prevalence, but real-world data are lacking. Methods: TD prevalence by year, payer, AP type (for patients with ≥2 AP claims), and comorbidity (schizophrenia [SCZ], bipolar disorder [BD], or mood disorders [MDs]) was calculated using data from patients aged ≥18 years from the All-Payer Claims Database (APCD) for 2016–2020. Results: Of 278,679,590 people in the APCD, 103,739 had a TD diagnosis, with overall prevalence 37.23/100,000. Patients with TD were 60.9% female, 41.8% White, and 55.1% aged 55–74 years. TD prevalence increased yearly during the study period (6.8/100,000 in 2016, 7.6/100,000 in 2017, 8.9/100,000 in 2018, 10.7/100,000 in 2019, and 11.53/100,000 in 2020). Prevalence was highest among patients with Medicare (78.9/100,000) or Medicaid (38.27/100,000) insurance. Among patients with AP claims, TD prevalence was highest for those with claims for both typical and atypical APs (2690.7/100,000), followed by only typical APs (1576.1/100,000) and only atypical APs (619.0/100,000). In addition, TD prevalence was highest among patients with recorded diagnosis of underlying SCZ (2899.3/100,000), followed by BD (883.9/100,000) and MDs (453.7/100,000). Conclusions: TD prevalence increased from 2016 through 2020, possibly because of increased awareness and availability of new treatments in 2017, yet TD may still be underdiagnosed. TD prevalence was greatest for Medicare or Medicaid beneficiaries, patients with claims for both typical and atypical APs, and patients with underlying SCZ. Additional research is needed to further elaborate on these findings.Short Description: Prevalence of tardive dyskinesia (TD) increased from 2016 through 2020 and was more prevalent in females and older adults. TD prevalence was highest among Medicare or Medicaid beneficiaries, patients with underlying schizophrenia, and patients with claims for both typical and atypical antipsychotic agents. TD prevalence was over two-fold higher in patients with claims for only typical antipsychotic agents than in those with claims for only atypical antipsychotic agents.Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D, Inc.