Abstract Details

Title Economic Burden Increased with Number of Treatment Failures in Migraine Patients - A Retrospective Claims Database Analysis in the United States

Topic Headache

Presentation(s) S47 - Headache 2 (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Objective To characterize health-care resource utilization (HCRU) and associated costs among migraine patients, categorized by number of preventive treatment failures (TF; 1TF, 2TF, ≥3TF).

Background Migraine is associated with substantial economic burden. However, information on burden associated with failed preventive treatments among migraine patients is limited.

Design/Methods This study used the IBM MarketScan^® Commercial and Medicare Supplemental database to identify newly diagnosed migraine patients for the period of January 1^st, 2011 to June 30^th, 2015. The number of TF was identified during the 2 years following initial migraine diagnosis, and HCRU and associated costs assessed in 12 months post-index. The index for 1TF patients was the date of their 2^ndpreventive treatment(PT) initiation, 2TF their 3^rd and ≥3TF patients their 4^th PT initiation.

Results Among 44,181 incident migraine patients, who had failed preventive treatments, 61.4% (27,112) had 1TF, 24% (10,583) had 2TF and 14.7% (6,486) had ≥3TF, respectively. The total medical (emergency room [ER] + inpatient [IP] + outpatient [OP]) per-patient cost increased with increase in number of TF (1TF: $10,329; 2TF: $13,774; ≥3+TF: $35,392). On adding prescription drug costs, the total health-care costs also increased with number of TF (1TF: $13,946; 2TF: $18,685; ≥3TF: $41,864). Similarly, the per-patient annual health-care provider visits increased with increase in number of TF. The number of ER visits/ year were 0.54, 0.69, and 1.02 for 1TF, 2TF, and ≥3TF patients respectively, while those for IP were 0.46, 0.59, and 0.97. A similar trend was seen with outpatient visits (office visits: 1TF: 9.47, 2TF: 11.24, ≥3TF: 14.26, other visits: 1TF: 13.15, 2TF: 15.73, ≥3TF: 19.96).

Conclusions The HCRU and associated costs were highest for ≥3TF patients, followed by 2TF and 1TF patients, suggesting that increase in TF is associated with increase in economic burden.

Authors/Disclosures
Lawrence C. Newman, MD, FAAN (Atria Institute) PRESENTER	Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan . Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Newman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Newman has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Newman has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Cristina Lopez Lopez, MD, PhD (Novartis)	No disclosure on file
Andy Cheadle, PhD (Novartis)	Dr. Cheadle has received personal compensation for serving as an employee of Novartis. Dr. Cheadle has stock in Novartis. Dr. Cheadle has stock in Teva.
	No disclosure on file
Juanzhi Fang	Juanzhi Fang has received personal compensation for serving as an employee of Novartis Pharmaceutical. Juanzhi Fang has received stock or an ownership interest from Novartis Pharmaceutical.

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