Abstract Details

Title Real-World Healthcare Costs and Resource Utilization Among Patients Treated With Erenumab in the United States: A Retrospective Claims Database Study

Topic Practice, Policy, and Ethics

Presentation(s) P16 - Poster Session 16 (8:00 AM-9:00 AM)

Poster/Presentation
Number 1-003

Objective To evaluate costs and healthcare resource utilization (HRU) among migraine patients treated with erenumab in the United States (US).

Background Migraine is a debilitating neurological disease and a leading cause of disability worldwide. Erenumab (erenumab-aooe in the US) was approved in the US in 2018 for the preventive treatment of migraine in adults. The effect of erenumab on healthcare costs and HRU in migraine patients has not been fully investigated.

Design/Methods Adults with three or more consecutive monthly claims for erenumab, from November 1, 2017 through September 1, 2019, were identified from the Komodo Health database (index date = first erenumab claim). Mean monthly migraine-related and all-cause healthcare costs ($2019) during the 180-day pre-index period were compared to varied follow-up periods to assess the short-(180 days post-index), mid-(91–270 days post-index), and longer-term (maximum available follow-up time) impact of the treatment. HRU was compared during the 180-day pre- versus the 180-day post-index period. Outcomes were adjusted for patient characteristics.

Results Overall, 1839 patients were included (mean age 47 years; 86% females). After erenumab initiation, there was a reduction in mean monthly migraine-related (P < 0.0001) and all-cause medical costs (P = 0.07) during the 180-day post-index period, which was associated with significant increase in migraine-related (P < 0.0001) and all-cause prescription costs (P < 0.0001). However, with an increase in follow-up time, up to 98% of the increased migraine-related and more than 100% of the all-cause prescription costs were offset by the reduced medical costs. A significant reduction in HRU during the 180-day post-index period was observed.

Conclusions

The entrance cost of erenumab treatment gets mitigated by reduced medical cost over a long-term follow-up, which suggests an improvement in disease management.

Authors/Disclosures
Judie B. Gutierrez, PhD (Eli Lilly) PRESENTER	Dr. Gutierrez has received personal compensation for serving as an employee of Impel Pharmaceuticals. Dr. Gutierrez has stock in Impel Pharmaceuticals.
Stewart J. Tepper, MD (The New England Institute for Neurology and Headache)	Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aeon. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aruene. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Atheneum. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Axsome Therapeutics. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Becker Pharmaceutical Consulting. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clearview Healhcare Partners. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CoolTech. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CRG. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Decision Resources. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Defined Health. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for DRG. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ExpertConnect. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for FCB Health. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fenix. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Health Advances. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Health Science Communications. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for HMP Communications. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Impel. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for InteractiveForums. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Keyquest. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Krog and Partners. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for M3 Global Research. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Magnolia Innovation. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MJH Holdings. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurolief. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for P Value Communications. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pain Insights Inc. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Palion Medical. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pulmatrix. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Putnam Associates. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SAI MedPartners. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Slingshot Insights. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Spherix Global Insights. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Strategy Inc. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for System Analytic. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Taylor and Francis. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Trinity Partners. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UnityHA. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for XOC. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Click Therapeutics. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Miravo. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurofront Therapeutics. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Rehaler. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Synapse Medical Communications. Dr. Tepper has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Pfizer. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alphasights. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Perfood. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for M3 Global Research. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Scilex. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Synapse Medical Communication. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tegus. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Catch Therapeutics. Dr. Tepper has received personal compensation in the range of $0-$499 for serving as a Consultant for DocDelta. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Dr Reddy's. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for FCB Health. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gilmartin Capital. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Initiator Pharma. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for IQVIA. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Magellan Health. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Nocira. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Slingshot Insights. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Third Bridge. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tonix. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vial . Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for DocDelta. The institution of Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bausch Health. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Dr Reddy's. The institution of Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biohaven. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ClickTherapeutics. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CoolTech. Dr. Tepper 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. Tepper has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Miravo Healthcare. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pulmatrix. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Satsuma. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Tepper has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Pfizer. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Scilex. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Tonix. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Dr Reddy's. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Anneal. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Axsome. The institution of Dr. Tepper has received research support from Abbvie. The institution of Dr. Tepper has received research support from Aeon. The institution of Dr. Tepper has received research support from Amgen. The institution of Dr. Tepper has received research support from Annovis. The institution of Dr. Tepper has received research support from Axsome. The institution of Dr. Tepper has received research support from Cassava. The institution of Dr. Tepper has received research support from Cognition. The institution of Dr. Tepper has received research support from Eli Lilly. The institution of Dr. Tepper has received research support from Inibikase. The institution of Dr. Tepper has received research support from Ipsen. The institution of Dr. Tepper has received research support from Lundbeck. The institution of Dr. Tepper has received research support from Merz. The institution of Dr. Tepper has received research support from Pfizer. The institution of Dr. Tepper has received research support from PrecisionMed. The institution of Dr. Tepper has received research support from Revance. The institution of Dr. Tepper has received research support from Suven. The institution of Dr. Tepper has received research support from UCB. The institution of Dr. Tepper has received research support from Biohaven. The institution of Dr. Tepper has received research support from Johnson and Johnson/Intracellular. The institution of Dr. Tepper has received research support from Karuna. The institution of Dr. Tepper has received research support from Neurocrine. Dr. Tepper has received publishing royalties from a publication relating to health care. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a CME Speaker with Diamond Headache Clinic. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CME Speaker with Medical Learning Institute Peerview. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CME Speaker with Medical ��ɫ�� Speakers Network. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a CME Speaker with Miller Medical Communications. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CME Speaker with Physicians' ��ɫ�� Resource. Dr. Tepper has received personal compensation in the range of $10,000-$49,999 for serving as a CME Speaker with WebMD/Medscape. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CME speaker with American Headache Society. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CME speaker with Vindico Medical ��ɫ��. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CME speaker with HMP Global. Dr. Tepper has received personal compensation in the range of $500-$4,999 for serving as a CMe speaker with Medical Learning Institute Peerview. Dr. Tepper has received personal compensation in the range of $5,000-$9,999 for serving as a Speaker with Consortium for Research ��ɫ�� Social Awareness and Training In Neurosciences.
Todd J. Schwedt, MD, FAAN (Mayo Clinic)	Dr. Schwedt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Schwedt has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scilex. Dr. Schwedt has stock in Aural Analytics. Dr. Schwedt has stock in Nocira. Dr. Schwedt has stock in Allevalux. The institution of Dr. Schwedt has received research support from National Institutes of Health. The institution of Dr. Schwedt has received research support from United States Department of Defense. The institution of Dr. Schwedt has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Schwedt has received research support from SPARK Neuro. The institution of Dr. Schwedt has received research support from Henry Jackson Foundation. The institution of Dr. Schwedt has received research support from Pfizer. The institution of Dr. Schwedt has received research support from National Headache Foundation. The institution of Dr. Schwedt has received research support from American Heart Association. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Ahmad Abdrabboh, PharmD	Ahmad Abdrabboh, PharmD has received personal compensation for serving as an employee of Novartis. Ahmad Abdrabboh, PharmD has received stock or an ownership interest from Novartis.
Matias Ferraris	Matias Ferraris has received personal compensation for serving as an employee of Novartis Pharma AG. An immediate family member of Matias Ferraris has received stock or an ownership interest from Novartis Pharma AG.
	No disclosure on file
	No disclosure on file

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