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Abstract Details

Health Care Resource Utilization and Economic Burden in Patients Cycling Through Multiple Triptans for Migraines: A Retrospective Analysis
Headache
P1 - Poster Session 1 (11:45 AM-12:45 PM)
12-001
Determine the triptan cycling burden by comparing medication use, MOH diagnoses, and migraine-specific HCRU and costs in patients treated with a single versus two or more triptans. 
Poor efficacy and tolerability to triptans may result in increased use of other migraine treatments, HCRU, and costs. 
This retrospective claims analysis used the MarketScan Databases(January 1, 2015-February 28, 2023). Patients ≥18yrs with migraines and ≥1 triptan prescription claim ≥January 1st, 2016, were divided into 2 cohorts: those continuing the same triptan (index fill with ≥1 refill) and those using ≥2 different triptans (≥1 fill index triptan, ≥1 fill different triptan) over a 24-month follow-up. The index date was the earliest triptan prescription claim. Patients with claims during 12-months pre-index were excluded. Descriptive statistics summarized baseline demographics and clinical characteristics. Chi-square tests compared post-index medication use. Regression models evaluated MOH, adjusted migraine-specific HCRU, and costs over a 24-month follow-up period.

Of 184,717 new triptan users, 91,406(49.5%) were in the 1 triptan cohort and 22,909(12.4%) were in the 2+ triptans cohort. In 1 triptan cohort, 32.1%, 18.1%, and 49.8% had 1, 2, and ≥3 refills, respectively. Patient demographics and clinical characteristics were similar between cohorts. 2+ triptans cohort had higher migraine-related acute treatment use excluding triptans (48.8% vs 29.6%) and preventive treatment use (83.1% vs 68.9%) versus 1 triptan cohort (all P<.001). Diagnosed MOH occurred in 3.5% and 1.1% of the 2+ and 1 triptan cohorts, respectively (odds ratio,2.98[95%CI,2.71-3.28]). Migraine-related ER, diagnostic imaging, and outpatient visits were 1.4, 1.3, and 1.4x higher in the 2+ triptan cohort. Adjusted migraine-related medical costs were $2,235 higher (mean ratio,1.88[95%CI,1.79-1.98]) and prescription costs were $1,939 higher (mean ratio,2.31[95%CI,2.23-2.41]) in the 2+ triptan cohort.

Cycling through ≥2 triptans was associated with higher treatment use, more MOH diagnoses, more ER visits, more diagnostic imaging, more outpatient visits, and higher costs. 
Authors/Disclosures
Krutika Jariwala-Parikh, PhD (AbbVie)
PRESENTER 		Dr. Jariwala-Parikh has received personal compensation for serving as an employee of AbbVie. Dr. Jariwala-Parikh has stock in AbbVie.
Jessica Ailani, MD, FAAN (Medstar Georgetown Neurology) Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Ailani has received personal compensation in the range of $0-$499 for serving as a Consultant for Eli Lilly. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Ailani has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merz. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aspya. Dr. Ailani has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bausch. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kallyope. Dr. Ailani has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Self Magazine. The institution of Dr. Ailani has received research support from Ipsen. The institution of Dr. Ailani has received research support from Parema. The institution of Dr. Ailani has received research support from Lundbeck. The institution of Dr. Ailani has received research support from Merz. The institution of Dr. Ailani has received research support from Pfizer. Dr. Ailani has received research support from Mi-Helper. The institution of Dr. Ailani has received research support from ShiraTronic. Dr. Ailani has a non-compensated relationship as a Executive Board Member with American Headache Society that is relevant to AAN interests or activities.
Amanda Howarth Miss Howarth has nothing to disclose.
Lauren Wilson Lauren Wilson has nothing to disclose.
Molly Duan (Abbvie) Molly Duan has received personal compensation for serving as an employee of AbbVie.
Amit Bodhani, Other (Abbvie) Mr. Bodhani has received personal compensation for serving as an employee of AbbVie. Mr. Bodhani has stock in AbbVie.
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 or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had 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.