Figure 1
Estimated Prevalence of Diagnosed Essential Tremor by Age Group and Case Definition (2022 Data From MarketScan).
aPrimary analysis: patients are considered to have diagnosed ET upon the second of at least two claims with a diagnosis of ET between 1 and 365 days apart during the study period.
bSensitivity analysis 1: patients are considered to have diagnosed ET upon the second of at least two claims with a diagnosis of ET between 1 and 730 days apart during the study period.
cSensitivity analysis 2: patients are considered to have diagnosed ET with a record of at least one ICD10 code, at any time during the study period.
The study period starts on 1/1/2016 and extends through 12/31/2022; n represents the respective denominator in the MarketScan data.
Table 1
Prevalence of diagnosed essential tremor (ET) in MarketScan in 2022, among adults overall and by age subgroup.
| OVERALL: AGE ≥18 YEARS NOT AGE-STANDARDIZED | AGE SUBGROUPS | ||||
|---|---|---|---|---|---|
| AGE 18–40 YEARS | AGE 41–64 YEARS | AGE 65–74 YEARS | AGE 75+ YEARS | ||
| Individuals at-riska; N (% of all adults at-risk) | 7,743,775 (100.0) | 2,950,151 (38.1) | 4,021,413 (51.9) | 404,069 (5.2) | 368,142 (4.8) |
| Primary analysis: At least two claims, 1–365 days apartb | |||||
| Patients with prevalent diagnosed ET; N | 21,780 | 1,894 | 10,028 | 3,915 | 5,943 |
| Prevalence of diagnosed ET; % (95% CI) | 0.28 (0.28, 0.29) | 0.06 (0.06, 0.07) | 0.25 (0.24, 0.25) | 0.97 (0.94, 1.00) | 1.61 (1.57, 1.66) |
| Prevalence of diagnosed ET; per 1,000 patients (95% CI) | 2.81 (2.78, 2.85) | 0.64 (0.61, 0.67) | 2.49 (2.44, 2.54) | 9.69 (9.39, 9.99) | 16.14 (15.74, 16.55) |
| Sensitivity analysis 1: At least two claims, 1–730 days apartc | |||||
| Patients with prevalent diagnosed ET; N | 23,576 | 2,079 | 10,926 | 4,214 | 6,357 |
| Prevalence of diagnosed ET; % (95% CI) | 0.30 (0.30, 0.31) | 0.07 (0.07, 0.07) | 0.27 (0.27, 0.28) | 1.04 (1.01, 1.07) | 1.73 (1.69, 1.77) |
| Prevalence of diagnosed ET; per 1,000 patients (95% CI) | 3.04 (3.01, 3.08) | 0.70 (0.67, 0.73) | 2.72 (2.67, 2.77) | 10.43 (10.12, 10.74) | 17.27 (16.85, 17.69) |
| Sensitivity analysis 2: At least one claimd | |||||
| Patients with prevalent diagnosed ET; N | 42,439 | 4,696 | 20,455 | 7,203 | 10,085 |
| Prevalence of diagnosed ET; % (95% CI) | 0.55 (0.54, 0.55) | 0.16 (0.16, 0.16) | 0.51 (0.50, 0.52) | 1.78 (1.74, 1.82) | 2.74 (2.69, 2.79) |
| Prevalence of diagnosed ET; per 1,000 patients (95% CI) | 5.48 (5.43, 5.53) | 1.59 (1.55, 1.64) | 5.09 (5.02, 5.16) | 17.83 (17.42, 18.23) | 27.39 (26.87, 27.92) |
[i] aIndividuals at risk include adults who are observable on each day of 2022 with at least 365 days of baseline observability prior to the start of 2022.
bPrimary analysis: patients are considered to have diagnosed ET upon the second of at least two claims with a diagnosis of ET between 1 and 365 days apart during the study period.
cSensitivity analysis 1: patients are considered to have diagnosed ET upon the second of at least two claims with a diagnosis of ET between 1 and 730 days apart during the study period.
dSensitivity analysis 2: patients are considered to have diagnosed ET upon the occurrence of at least one claim with a diagnosis of ET during the study period.
Age assessed on 1/1/2022.
95% CI estimated as follows: letting n be the number of patients and p the observed proportion of successes, if np(1-p) < 5, the Clopper-Pearson method is used; otherwise, the Wald interval is used.
The study period starts on 1/1/2016 and extends through 12/31/2022.
CI, confidence interval; ET, essential tremor.
Table 2
Proportion of patients receiving possible treatment in 2022 in MarketScan among patients with diagnosed essential tremor (ET), overall and by age subgroup.
| OVERALL: AGE ≥18 YEARS NOT AGE-STANDARDIZED | AGE SUBGROUPS | ||||
|---|---|---|---|---|---|
| AGE 18–40 YEARS | AGE 41–64 YEARS | AGE 65–74 YEARS | AGE 75+ YEARS | ||
| Patients with diagnosed ET in 2022a; N | 19,511 | 1,702 | 8,927 | 3,473 | 5,409 |
| Patients diagnosed with ET who received possible treatment in 2022b; N | 14,397 | 893 | 6,526 | 2,733 | 4,245 |
| Proportion of patients who received possible treatment; % (95% CI) | 73.79% (73.17%, 74.41%) | 52.47% (50.10%, 54.84%) | 73.10% (72.18%, 74.02%) | 78.69% (77.33%, 80.06%) | 78.48% (77.34%, 79.58%) |
[i] aPatients at risk include patients with at least two claims with a diagnosis of ET who are observable on each day of 2022, who have at least 365 days of baseline observability prior to the start of 2022, and 6 months (180 days) of additional follow-up observability following first ET diagnosis (second of two claims with a diagnosis code for ET, 1–365 days apart).
bPatients are considered to have received treatment if a claim for possible ET treatment is observed on or after the first ET diagnosis (second of two claims with a diagnosis code for ET, 1–365 days apart) during the study period.
Age assessed on 1/1/2022.
95% CI estimated as follows: letting n be the number of patients and p the observed proportion of successes, if np(1-p) < 5, the Clopper-Pearson method is used; otherwise, the Wald interval is used.
The study period starts on 1/1/2016 and extends through 12/31/2022.
CI, confidence interval; ET, essential tremor.
Table 3
Top treatments by class and medication observed in 2022 in MarketScan following first observed prevalent essential tremor (ET) diagnosis, among adults with prevalent diagnosed ET who received possible treatment, overall and by age subgroup.
| OVERALL: AGE ≥18 YEARS NOT AGE-STANDARDIZED | AGE SUBGROUPS | ||||
|---|---|---|---|---|---|
| AGE 18–40 YEARS | AGE 41–64 YEARS | AGE 65–74 YEARS | AGE 75+ YEARS | ||
| Patients with prevalent 2022 ET who received possible treatmenta; N | 14,397 | 983 | 6,526 | 2,733 | 4,245 |
| Patients with treatment in 2022 by treatment class; N (%) | |||||
| Beta blockers | 9,398 (65.3) | 554 (62.0) | 4,194 (64.3) | 1,770 (64.8) | 2,880 (67.8) |
| Anticonvulsants | 7,723 (53.6) | 356 (39.9) | 3,414 (52.3) | 1,581 (57.8) | 2,372 (55.9) |
| Benzodiazepines | 2,545 (17.7) | 169 (18.9) | 1,368 (21.0) | 470 (17.2) | 538 (12.7) |
| Antidepressants | 2,037 (14.1) | 134 (15.0) | 902 (13.8) | 415 (15.2) | 586 (13.8) |
| Botulinum toxins (A) | 499 (3.5) | 42 (4.7) | 297 (4.6) | 73 (2.7) | 87 (2.0) |
| Calcium channel blockers | 428 (3.0) | 10 (1.1) | 152 (2.3) | 104 (3.8) | 162 (3.8) |
| Antipsychotics | 196 (1.4) | 28 (3.1) | 82 (1.3) | 37 (1.4) | 49 (1.2) |
| Carbonic anhydrase inhibitors | 78 (0.5) | 13 (1.5) | 31 (0.5) | 9 (0.3) | 25 (0.6) |
| Potassium channel blockers | 6 (0.0) | 0 (0.0) | 5 (0.1) | 1 (0.0) | 0 (0.0) |
| Patients with treatment in 2022 by medication; N (%) | |||||
| Beta blockers: propranolol | 6,048 (42.0) | 502 (56.2) | 3,104 (47.6) | 1,014 (37.1) | 1,428 (33.6) |
| Anticonvulsants: primidone | 3,833 (26.6) | 111 (12.4) | 1,492 (22.9) | 867 (31.7) | 1,363 (32.1) |
| Anticonvulsants: gabapentin | 3,280 (22.8) | 127 (14.2) | 1,524 (23.4) | 655 (24.0) | 974 (22.9) |
| Beta blockers: metoprolol | 2,983 (20.7) | 42 (4.7) | 946 (14.5) | 684 (25.0) | 1,311 (30.9) |
| Antidepressants: trazodone | 1,537 (10.7) | 107 (12.0) | 751 (11.5) | 316 (11.6) | 363 (8.6) |
| Benzodiazepines: alprazolam | 1,402 (9.7) | 80 (9.0) | 721 (11.0) | 270 (9.9) | 331 (7.8) |
| Anticonvulsants: topiramate | 1,371 (9.5) | 95 (10.6) | 710 (10.9) | 266 (9.7) | 300 (7.1) |
| Benzodiazepines: clonazepam | 1,221 (8.5) | 98 (11.0) | 686 (10.5) | 214 (7.8) | 223 (5.3) |
| Anticonvulsants: pregabalin | 761 (5.3) | 31 (3.5) | 391 (6.0) | 174 (6.4) | 165 (3.9) |
| Antidepressants: mirtazapine | 589 (4.1) | 38 (4.3) | 183 (2.8) | 117 (4.3) | 251 (5.9) |
| Beta blockers: atenolol | 489 (3.4) | 14 (1.6) | 202 (3.1) | 102 (3.7) | 171 (4.0) |
| Botulinum toxins: onabotulinumtoxinA | 451 (3.1) | 40 (4.5) | 268 (4.1) | 64 (2.3) | 79 (1.9) |
| Anticonvulsants: levetiracetam | 411 (2.9) | 52 (5.8) | 165 (2.5) | 65 (2.4) | 129 (3.0) |
| Calcium channel blockers: nifedipine | 239 (1.7) | 4 (0.4) | 69 (1.1) | 55 (2.0) | 111 (2.6) |
| Antipsychotics: olanzapine | 183 (1.3) | 24 (2.7) | 79 (1.2) | 34 (1.2) | 46 (1.1) |
| Calcium channel blockers: verapamil | 190 (1.3) | 6 (0.7) | 84 (1.3) | 49 (1.8) | 51 (1.2) |
| Anticonvulsants: zonisamide | 159 (1.1) | 14 (1.6) | 78 (1.2) | 25 (0.9) | 42 (1.0) |
| Beta blockers: nadolol | 126 (0.9) | 4 (0.4) | 57 (0.9) | 26 (1.0) | 39 (0.9) |
| Beta blockers: sotalol | 74 (0.5) | 1 (0.1) | 14 (0.2) | 13 (0.5) | 46 (1.1) |
| Carbonic anhydrase inhibitors: acetazolamide | 61 (0.4) | 13 (1.5) | 27 (0.4) | 4 (0.1) | 17 (0.4) |
| Botulinum toxins: incobotulinumtoxinA | 42 (0.3) | 2 (0.2) | 25 (0.4) | 7 (0.3) | 8 (0.2) |
| Antipsychotics: clozapine | 13 (0.1) | 4 (0.4) | 3 (0.0) | 3 (0.1) | 3 (0.1) |
| Botulinum toxins: abobotulinumtoxinA | 11 (0.1) | 0 (0.0) | 8 (0.1) | 2 (0.1) | 1 (0.0) |
| Carbonic anhydrase inhibitors: methazolamide | 18 (0.1) | 1 (0.1) | 4 (0.1) | 5 (0.2) | 8 (0.2) |
| Anticonvulsants: perampanel | 6 (0.0) | 0 (0.0) | 5 (0.1) | 1 (0.0) | 0 (0.0) |
| Beta blockers: pindolol | 6 (0.0) | 0 (0.0) | 3 (0.0) | 1 (0.0) | 2 (0.0) |
| Calcium channel blockers: nimodipine | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Potassium channel blockers: perampanel | 6 (0.0) | 0 (0.0) | 5 (0.1) | 1 (0.0) | 0 (0.0) |
| Patients treated with surgical therapies in 2022; N (%) | |||||
| Deep brain stimulation | 38 (0.3) | 2 (0.2) | 18 (0.3) | 14 (0.5) | 4 (0.1) |
| Radio-surgical gamma knife thalamotomy | 24 (0.2) | 0 (0.0) | 6 (0.1) | 10 (0.4) | 8 (0.2) |
| Focused ultrasound | 17 (0.1) | 0 (0.0) | 7 (0.1) | 3 (0.1) | 7 (0.2) |
[i] aPatients are considered to have received treatment if a claim for possible ET treatment is observed on or after the first ET diagnosis (second of two claims with a diagnosis code for ET, 1–365 days apart) during the study period.
Age assessed on 1/1/2022.
The study period starts on 1/1/2016 and extends through 12/31/2022.
ET, essential tremor.
Table 4
Estimated number of patients with essential tremor (ET) in the United States (US) in 2024, adults overall and by age subgroup.
| OVERALL: ≥18 YEARS AGE-STANDARDIZED ESTIMATEa | AGE SUBGROUPS | ||||
|---|---|---|---|---|---|
| 18–40 YEARS | 41–64 YEARS | 65–74 YEARS | 75+ YEARS | ||
| Number of people in the US population, 2024 | 267,400,939 | 104,825,019 | 99,221,580 | 35,876,763 | 27,477,577 |
| Primary analysis: At least two claims, 1–365 days apartb | |||||
| Prevalence of diagnosed ET (%) | 0.42 | 0.06 | 0.25 | 0.97 | 1.61 |
| Estimated number of patients in the US with diagnosed ETc | 1,123,500 | 67,298 | 247,424 | 639,545 | 752,730 |
| Proportion of patients with diagnosed ET who received possible treatment (%) | 73.79 | 52.47 | 73.10 | 78.69 | 78.48 |
| Estimated number of patients in the US with ET who received possible treatmentd | 851,590 | 35,310 | 180,877 | 273,542 | 348,120 |
| Sensitivity analysis 1: At least two claims, 1–730 days aparte | |||||
| Prevalence of diagnosed ET (%) | 0.45 | 0.07 | 0.27 | 1.04 | 1.73 |
| Estimated number of patients in the US with diagnosed ETc | 1,210,726 | 73,871 | 269,581 | 374,156 | 474,477 |
| Sensitivity analysis 2: At least one claimf | |||||
| Prevalence of diagnosed ET (%) | 0.78 | 0.16 | 0.51 | 1.78 | 2.74 |
| Estimated number of patients in the US with diagnosed ETc | 2,089,908 | 166,859 | 504,693 | 639,545 | 752,730 |
[i] aThe total number of adults age ≥18 years in the US diagnosed with ET is calculated by summing across the age-specific estimates. The age-specific N’s are calculated by applying the age group-specific adult prevalence estimates to the corresponding US population estimate.
bPrimary analysis: patients are considered to have diagnosed ET upon the second of at least two claims with a diagnosis of ET between 1 and 365 days apart during the study period.
c(Prevalence of diagnosed ET [95% CI]) ×(Number of patients in the US population).
d(Proportion of patients with diagnosed ET at risk who received possible treatment) × (Number of patients in the US population).
eSensitivity analysis 1: patients are considered to have diagnosed ET upon the second of at least two claims with a diagnosis of ET between 1 and 730 days apart during the study period.
fSensitivity analysis 2: patients are considered to have diagnosed ET upon the occurrence of at least one claim with a diagnosis of ET during the study period.
Prevalence of diagnosed ET is calculated as described in Table 1. Proportion of patients with diagnosed ET is calculated as described in Table 2.
US population estimates are based on 2024 estimates from the International Database of the U.S. Census Bureau International Programs Center https://www.census.gov/data-tools/demo/idb/#/pop?menu=popViz.
ET, essential tremor.