Treatment Patterns and Healthcare Resource Utilization by Gender and Migraine Frequency in Adult Patients Receiving Galcanezumab Versus Standard of Care Preventive Medications Over 24 months: A United States Retrospective Claims Study.

Objective: To describe 24-month treatment patterns, healthcare resource utilization (HCRU), and direct costs of patients initiating galcanezumab (GMB) versus standard of care migraine preventive medications (SOC), stratified by gender and migraine type.

Methods: This retrospective cohort study used Optum's^® de-identified Market Clarity database (September 2018-March 2020) and included adults with migraine with ≥1 claim for GMB or SOC. Patients in the GMB cohort were stratified by gender (female/male) and migraine type (CM/EM), and propensity score matched 1:1 to patients in the SOC cohort. Treatment patterns, all-cause and migraine-related HCRU, and direct costs for GMB versus SOC cohorts were compared using a Z-test and reported over 24 months.

Results: Following stratification and matching, the GMB and SOC cohorts included the following patient pairs: 2015-female, 292-male, 1024-CM, and 1282-EM. Treatment adherence, measured by proportion of days covered, and median time to treatment discontinuation were significantly greater in those initiating GMB compared with SOC in females, males, patients with CM, and patients with EM (all p <0.001). Over 24 months, reduction in migraine-related ambulatory visits, office visits, and medical costs were significantly higher in GMB versus SOC cohorts in females and patients with CM. Increases in HCRU associated with preventive migraine medication counts and migraine-related total and pharmacy costs were significantly higher in GMB versus SOC cohorts in all subgroups.

Conclusion: While direct costs over 24 months were higher in patients initiating GMB for migraine prevention, better adherence and longer treatment duration with GMB regardless of gender or migraine type support the use of GMB compared with SOC.