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IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2024-12-16 DOI:10.1007/s12325-024-03072-9

Gilwan Kim, Margaret Hoyt, Armen Zakharyan, Jennifer Durica, Alexandra Wallem, Lars Viktrup

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引用次数: 0

摘要

简介迄今为止，还没有研究比较过用于预防偏头痛的两种降钙素基因相关肽拮抗剂 galcanezumab（单克隆抗体，每月皮下注射）和 rimegepant（口服 gepant，每隔一天服用一次）的医疗资源利用率（HCRU）、费用和停药情况。本研究旨在评估商业/医保受益人在开始治疗后 12 个月内的全因和偏头痛相关 HCRU、费用和治疗中断情况，这些受益人患有发作性偏头痛，接受加康珠单抗和利美君作为预防性偏头痛治疗：这项回顾性研究使用了 Merative™ MarketScan® 研究数据库（2020 年 6 月至 2023 年 6 月）。患有发作性偏头痛的成人被归入加康单抗（索赔次数≥ 1 次）或利美昔单抗队列（索赔次数≥ 1 次，且在指数期间索赔次数≥ 15 次）。使用 Wilcoxon 符号秩检验和卡方检验确定倾向得分匹配队列之间全因和偏头痛相关 HCRU 及费用与基线相比的变化。采用 Kaplan-Meier 分析和 Cox 比例危险度模型评估治疗中断情况：结果：在12个月的随访期间，两个队列中全因和偏头痛相关的HCRU和费用都有所增加。在12个月的随访中，galcanezumab队列的平均全因医疗+药房总费用增幅（低21%）和偏头痛相关医疗+药房总费用增幅（低76%）明显低于利美康队列（p 60天差距），galcanezumab队列为244.6（135.3），利美康队列为178.1（141.1）（p 结论：在配对患者中，galcanezumab队列和利美康队列的平均全因医疗+药房总费用增幅（低21%）和偏头痛相关医疗+药房总费用增幅（低76%）明显低于利美康队列（p 60天差距）：在配对的患者中，两组发作性偏头痛患者在 12 个月内的全因和偏头痛相关总费用均有所增加。然而，加康单抗队列的增加幅度明显低于利美昔班队列。加卡尼珠单抗组的治疗中断率明显低于利美昔班组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Healthcare Utilization, Costs, and Treatment Discontinuation in Adults with Episodic Migraine Initiating Galcanezumab Versus Rimegepant: A US Retrospective Claims Analysis.

Introduction: To date, no study has compared the healthcare resource utilization (HCRU), costs, and discontinuation of the two calcitonin gene-related peptide antagonists, galcanezumab (monoclonal antibody subcutaneously injected monthly) and rimegepant (oral gepant taken every other day), for migraine prevention. This study aimed to assess all-cause and migraine-related HCRU, costs, and treatment discontinuation at 12 months following treatment initiation in commercial/Medicare beneficiaries with episodic migraine who received galcanezumab versus rimegepant as preventive migraine treatment.

Methods: This retrospective study used the Merative™ MarketScan^® Research Databases (June 2020-June 2023). Adults with episodic migraine were grouped into the galcanezumab (≥ 1 claim) or rimegepant cohort (≥ 1 claim with quantity ≥ 15 during the index period). Changes from baseline in all-cause and migraine-related HCRU and cost between the propensity score-matched cohorts were determined using Wilcoxon signed rank test and chi-square test. Treatment discontinuation was assessed using Kaplan-Meier analysis and Cox proportional hazards model.

Results: All-cause and migraine-related HCRU and costs increased over the 12-month follow-up in both cohorts. The galcanezumab cohort had a significantly lower increase in mean all-cause total medical + pharmacy costs (21% lower) and migraine-related total medical + pharmacy costs (76% lower) than the rimegepant cohort at the 12-month follow-up (p < 0.0001 for both assessments). Mean (standard deviation) number of days from initiation to discontinuation (> 60-day gap) was 244.6 (135.3) for galcanezumab cohort and 178.1 (141.1) for rimegepant cohort (p < 0.0001). Treatment discontinuation rate was 1.8 times less likely in the galcanezumab cohort than the rimegepant cohort (hazard ratio = 1.81, 95% confidence interval = 1.56-2.10). Similar trends were observed using a 30-day gap.

Conclusion: Among matched patients, both cohorts of patients with episodic migraine showed all-cause and migraine-related total cost increases over 12 months. However, the magnitude of the increases was significantly lower for the galcanezumab cohort than for the rimegepant cohort. Treatment discontinuation rate was significantly lower in the galcanezumab versus the rimegepant cohort.

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) 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 therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in 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.