Abstract Details

Title Higher Health Care Resource Utilization and Costs Among Patients With Potentially Insufficient Response to Triptans

Topic Headache

Presentation(s) S47 - Headache 2 (2:12 PM-2:24 PM)

Poster/Presentation
Number 007

Objective To characterize healthcare resource utilization and costs among new triptan users in a commercially insured US population.

Background Triptans are the most commonly prescribed medication class for acute treatment of migraine attacks; however, real-world observational studies have demonstrated low persistence.

Design/Methods Adult patients with ≥1 triptan claim between January 1, 2013 and December 31, 2013 (first claim assigned as index date) and ≥12 months of pre-index and 24 months of post-index continuous enrollment in the Optum Clinformatics^® Data Mart claims database were examined. Patients were required to have ≥1 migraine diagnosis but no prior triptan claims in the pre-index period. Migraine-related inpatient, outpatient, and emergency department (ED) visit frequencies and costs were examined. Triptan users who refilled only triptan prescriptions were considered optimized; new users who did not refill their index triptan but used non-triptan acute treatments, or new users who continued using a triptan but supplemented it with non-triptan acute treatments for migraine, were considered not optimized (ie, potential triptan insufficient responders [TIRs]). Triptan users who did not refill their index triptan or any other acute medication for migraine were not analyzed.

Results Of 10,509 new triptan users included in the analysis, 3,102 (30%) were potential TIR patients. Over 24 months, potential TIR patients had more migraine-related physician visits, inpatient visits, and ED visits (all P<0.05) and higher all-cause total costs, migraine-related total costs, and migraine-related medical costs (all P<0.05) than patients who continued using triptans. Adjusted total migraine-related costs were $2,905 higher in months 0-12 post-index and $2,615 higher in months 13-24 post-index for potential TIR patients than for those who continued using triptans (both P<0.05).

Conclusions Patients with potentially insufficient response to triptans have higher healthcare resource utilization and higher migraine-related total costs than patients who are potentially optimized on triptans for acute treatment of migraine.

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.
Stephen D. Silberstein, MD, FAAN (Jefferson Headache Center)	Dr. Silberstein has received publishing royalties from a publication relating to health care.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
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.
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

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