Real-World Treatment and Associated Healthcare Resource Use Among Migraine Patients in Germany

Abstract

Background: In order to evaluate unmet therapeutic need, this study sought to describe treatment patterns, as well as associated healthcare resource use (HCRU) and costs incurred by migraine patients in Germany. Methods: We conducted a retrospective analysis of a German claims dataset from 2013-2017, including over three million publicly-insured patients. Adult patients were included if they received at least one inpatient and/or two confirmed outpatient claims for headache/migraine from 2013-2016. Using prescription data from 2017, patients were separated into four main cohorts: those receiving prescriptions for (1) acute agents only, (2) prophylactic agents only, (3) both acute and prophylactic agents, and (4) neither acute nor prophylactic agents. Baseline characteristics were observed from 2013-2016; treatment and HCRU/cost outcomes were assessed in 2017. Results: In total, 199,283 patients were included in this analysis (mean age, 49.49 years; 73.04%, female) and 9,005 prophylactic therapy starters were identified. Overall, 43.47% of migraine patients did not receive acute or prophylactic medication in 2017, while 33.81% received only acute treatment, 9.45% received only prophylactic medication and 13.28% received both. Only 28.90% of patients initiating a prophylactic treatment were persistent after two years. HCRU was elevated for all groups, while direct costs ranged from €2,288-7,246 per year, and indirect costs ranged from €868-1,859. Conclusions: Despite high levels of HCRU, few migraine patients were treated with prophylactic agents, and those who did were at an elevated risk of early discontinuation. Ultimately, these findings indicate a resounding need for safe, timely, and efficacious use of prophylaxis among migraine patients.