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Abstract Details

Undiagnosed Chronic Migraine Is Associated With Higher Economic Burden Compared With Diagnosed Chronic Migraine: Results From a Claims-Based Retrospective Study
Headache
P4 - Poster Session 4 (5:30 PM-6:30 PM)
13-004
To apply a claims-based algorithm to identify potentially undiagnosed chronic migraine (CM) patients and compare 12-month direct costs of potentially undiagnosed versus diagnosed CM patients.

Approximately 7.7% of those with migraine have a CM diagnosis; however, it is estimated that 75% of those with CM are undiagnosed. Little is known about the economic burden of undiagnosed CM.
Adults having ≥2 migraine diagnoses (346.xx) ≥30 days apart with migraine claims between 7/1/14 and 6/30/15 and continuously enrolled ≥12 months pre- and post-index date were identified from a large US claims database. Patients with ≥2 CM diagnoses (346.7x) ≥30 days apart were assigned to diagnosed CM cohort. A recently developed algorithm was applied to identify potentially undiagnosed CM patients from the group of migraine patients without diagnosed CM (ie, no claim for 346.7x or onabotulinumtoxinA during study period). Algorithm predicts CM status based on gender, number of acute medication claims, unique preventive classes, and healthcare visits; it has 78% sensitivity and 73% specificity. The 12-month post-index all-cause costs were compared between diagnosed CM and potentially undiagnosed CM cohorts. Generalized linear models controlling for patient age, gender, region, plan type, comorbidity score, and other migraine-related comorbidities were used to estimate adjusted costs.

Study included 5555 diagnosed CM patients and 12,780 potentially undiagnosed CM patients. Mean adjusted total direct costs were significantly higher for undiagnosed CM group ($26,019) than for diagnosed CM group ($22,826, P<0.05). Mean adjusted medical costs for undiagnosed CM patients ($21,973) were higher than for diagnosed CM patients ($17,433, P<0.05). Mean adjusted pharmacy costs for undiagnosed CM patients ($3856) were lower versus diagnosed CM patients ($4928, P<0.05).
Undiagnosed CM was associated with significantly higher total healthcare costs and direct medical costs than diagnosed CM. Initiatives to better identify and manage such patients are needed.
Authors/Disclosures

PRESENTER 		No disclosure on file
Anand R. Shewale (AbbVie) Anand R. Shewale has received personal compensation for serving as an employee of AbbVie. Anand R. Shewale has stock in AbbVie.
William B. Young, MD, FAAN (Jefferson Headache Center) Dr. Young has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven Pharmaceuticals. Dr. Young has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly and Company. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven Pharmaceuticals Inc. Dr. Young has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly and Company. Dr. Young has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Young has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Coalition for Headache and Migraine Patients. Dr. Young has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Miles for Migraine. The institution of Dr. Young has received research support from Amgen. The institution of Dr. Young has received research support from Cumberland. The institution of Dr. Young has received research support from Eli Lilly. The institution of Dr. Young has received research support from Novartis. The institution of Dr. Young has received research support from PCORI. The institution of Dr. Young has received research support from Satsuma. The institution of Dr. Young has received research support from Scion. The institution of Dr. Young has received research support from Teva. The institution of Dr. Young has received research support from Zosano.
Justin S. Yu No disclosure on file
Jelena M. Pavlovic, MD, PhD (Albert Einstein College of Medicine) Dr. Pavlovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven.
Hema Viswanathan Ms. Viswanathan has received personal compensation for serving as an employee of Allergan plc. Ms. Viswanathan has received personal compensation for serving as an employee of Precision Medicine Group. Ms. Viswanathan has received stock or an ownership interest from Allergan plc. Ms. Viswanathan has received stock or an ownership interest from Precision Medicine Group.
No disclosure on file