Abstract Details

Title Healthcare Resource Use and Costs Associated with the Misdiagnosis of Migraine

Topic Headache

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-004

Objective Compare HCRU (health care resource utilization) and healthcare costs in patients with migraine with or without a history of misdiagnosis.

Background Despite the high prevalence of migraine, migraine is commonly misdiagnosed. The healthcare resource use and cost burden of a misdiagnosis is unknown.

Design/Methods This retrospective cohort study identified adults with an incident migraine diagnosis from the Merative^™ Marketscan^®Commercial and Medicare Supplemental Databases between June 2018-2019. Patients with a diagnosis of commonly considered misdiagnoses (headache, sinusitis, or cervical pain) before their migraine diagnosis were classified as misdiagnosed-correctly diagnosed cohort (MD-CD). Patients in the MD-CD cohort were potentially misdiagnosed, then eventually received a correct diagnosis. Patients without a history of commonly considered misdiagnoses prior to their migraine diagnosis were classified as correctly diagnosed cohort (CD). HCRU and healthcare costs were assessed in the period before migraine diagnosis and compared between the cohorts. Outcomes were reported as per patient per month (PPPM) and compared with incidence rate ratios (IRR) adjusted for age, sex, region, plan type, and comorbidities.

Results 29,147 CD and 3,841 MD-CD patients met inclusion criteria. Adjusting for baseline characteristics, MD-CD patients had statistically significant higher rates of inpatient admissions (IRR:1.61, 95% CI 1.47–1.74), emergency department (ED) visits (IRR:1.92, 95% CI 1.82–2.03), neurologist visits (IRR:5.92, 95% CI 5.37–6.54), and non-neurologist outpatient visits (IRR:1.67, 95% CI 1.62–1.72) and prescription fills (IRR:1.52, 95% CI 1.47–1.57) compared to CD patients. MD-CD patients had statistically significant higher rates of healthcare cost accrual for inpatient admissions (IRR:2.54, 95% CI 2.42-2.62), ED visits (IRR:2.27, 95% CI 2.20–2.32), neurologist visits (IRR:4.33, 95% CI 3.81–4.52), non-neurologist outpatient visits (IRR:2.06, 95% CI 1.91–2.23), and prescription fills (IRR:1.36, 95% CI 1.13–1.63) compared to CD patients.

Conclusions Patients with migraine with a history of misdiagnoses have higher rates of HCRU, and cost accrual versus those without such history.

Authors/Disclosures
Tae Jin Park (AbbVie) PRESENTER	Mr. Park has received personal compensation for serving as an employee of AbbVie. Mr. Park has stock in AbbVie.
Jae Kim (AbbVie)	No disclosure on file
Maria Agapova	No disclosure on file
Andrew M. Blumenfeld, MD, FAAN (Cedars Sinai)	Dr. Blumenfeld has received personal compensation for serving as an employee of The Los Angeles Headache Center. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Allergan/Abbvie. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Best Doctors. Dr. Blumenfeld has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Guidepoint. Dr. Blumenfeld has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GLG. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Theranica. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Aeon. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Revance. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lilly. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Lundbeck. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Axsome. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Axon. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Cedar Sinai. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance. Dr. Blumenfeld has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axsome. Dr. Blumenfeld has received personal compensation in the range of $100,000-$499,999 for serving on a Speakers Bureau for Allergan/Abbvie. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Teva. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Lilly. Dr. Blumenfeld has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Lundbeck. Dr. Blumenfeld has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for AXSOME.
Jonathan H. Smith, MD (AbbVie)	Dr. Smith has received personal compensation for serving as an employee of AbbVie. Dr. Smith has stock in AbbVie.
Darshini Shah, Other (AbbVie Inc)	Ms. Shah has received personal compensation for serving as an employee of AbbVie. Ms. Shah has stock in AbbVie Inc. An immediate family member of Ms. Shah has received research support from National Institutes of Health.
Beth Devine (University of Washington, The CHOICE Institute)	No disclosure on file

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