Changes in Use of Migraine Medications, Healthcare Resource Utilization, and Associated Direct Costs Over 12 Months Following Initiation of Erenumab: A US Retrospective Real-World Analysis.

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Pain and Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI:10.1007/s40122-024-00644-z
Robert Urman, Nicole Princic, Fiston Vuvu, Leah B Patel, Sam Oh, David Chandler, Nada Hindiyeh, Mark E Bensink
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引用次数: 0

Abstract

Introduction: Erenumab-aooe is approved for the preventive treatment of migraine in adults. Recent publications have evaluated migraine medication use during the 6 months after starting erenumab, but longer-term follow-up data are limited. The objective of this study was to describe 12-month medication use and changes in healthcare resource utilization (HRU) and associated direct costs among patients initiating erenumab.

Methods: We identified adult patients with an erenumab claim in the Merative MarketScan Commercial and Medicare Databases from May 2018 through September 2019. Eligible patients had ≥ 12 months of continuous medical and pharmacy coverage before (pre-index period) and after (post-index period) the index date (first erenumab claim) in addition to pre-index evidence of migraine. Patients were stratified by post-index-period adherence to erenumab, defined as ≥ 80% of days covered (adherent) or < 80% of days covered (non-adherent). Outcomes were measured pre- and post-index, and differences between these periods were described.

Results: Among 7528 eligible patients, the mean (standard deviation) age was 45.1 (11.4) years and 85.4% were female; 38.5% of patients were adherent to erenumab. Most patients used acute or traditional migraine-preventive medications pre-index, with reductions in use observed post-index (acute medication was used by 95.6% of patients pre-index, compared to 92.3% post-index; traditional preventive medication was used by 89.6% of patients pre-index, compared to 81.9% post-index). Reductions were observed for HRU of emergency room visits (- 3.8%) and brain- and other head-imaging studies (- 7.5%). Overall costs associated with acute and traditional preventive medications were reduced (- $764), but costs for HRU increased slightly ($76). When stratifying by adherence and combining costs for acute and traditional preventive medications and HRU, adherent patients had cost decreases (- $1947), while non-adherent patients had cost increases ($101).

Conclusion: Most patients initiating erenumab had prior use of acute and traditional migraine-preventive therapies. The reduction in acute and traditional migraine-preventive medication use and HRU over the 12-month follow-up supports the long-term clinical benefits of erenumab in the real-world setting.

Abstract Image

开始使用艾伦单抗后 12 个月内偏头痛药物使用、医疗资源利用和相关直接成本的变化:美国回顾性真实世界分析。
简介艾伦单抗已被批准用于成人偏头痛的预防性治疗。最近发表的文章对开始使用艾伦单抗后 6 个月内偏头痛的用药情况进行了评估,但长期随访数据有限。本研究旨在描述开始使用艾伦单抗的患者在12个月内的用药情况以及医疗资源利用率(HRU)和相关直接费用的变化:我们在 Merative MarketScan 商业和医疗保险数据库中确定了 2018 年 5 月至 2019 年 9 月期间有艾伦单抗索赔的成年患者。符合条件的患者在指数日期(首次艾伦单抗索赔)之前(指数前期间)和之后(指数后期间)连续投保医疗和药房保险≥12个月,此外还需有指数前偏头痛的证据。根据患者在指数期后对艾伦单抗的依从性进行分层,依从性的定义是≥80%的承保天数(依从)或结果:在7528名符合条件的患者中,平均年龄(标准差)为45.1(11.4)岁,85.4%为女性;38.5%的患者坚持使用艾伦单抗。大多数患者在指标实施前使用急性或传统偏头痛预防药物,指标实施后使用率有所下降(95.6%的患者在指标实施前使用急性药物,92.3%的患者在指标实施后使用急性药物;89.6%的患者在指标实施前使用传统预防药物,81.9%的患者在指标实施后使用传统预防药物)。急诊室就诊的 HRU(- 3.8%)和脑部及其他头部成像检查的 HRU(- 7.5%)均有所下降。与急性期和传统预防性药物相关的总体费用有所降低(- 764 美元),但 HRU 的费用略有增加(76 美元)。如果按照依从性进行分层,并将急性和传统预防性药物及 HRU 的成本合并计算,依从性患者的成本降低(- 1947 美元),而非依从性患者的成本增加(101 美元):结论:大多数开始使用艾伦单抗的患者都曾使用过急性和传统偏头痛预防疗法。在12个月的随访中,急性和传统偏头痛预防药物的使用量和HRU均有所减少,这支持了艾伦单抗在实际环境中的长期临床疗效。
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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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