Abstract Details

Title Impact of Triptan Insufficient Response on Medication Use, Health Care Utilization, and Costs: A Retrospective Claims Study

Topic Headache

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-002

Objective

This study aimed to assess medication use and migraine-specific healthcare resource use (HCRU) and costs in patients with a potential insufficient response to triptans compared to patients who continue on triptans.

Background

Patients who do not adequately respond to triptans may have suboptimal outcomes.

Design/Methods

Adult migraine patients with ≥1 triptan claim (index date) were identified from the MarketScan Commercial Database (2019 – 2022). Patients with ≥1 triptan claim in the 12 months pre-index were excluded. Two cohorts were formed: triptan continuers (patients with >1 triptan refill AND 0 fills for any non-triptan acute migraine medications) and potential triptan insufficient responders (TIR) (patients with 0/1 triptan refill AND ≥1 fill for any non-triptan acute medication).

Results Among the 30,477 included patients, 12,858 (42.2%) were classified as triptan continuers and 9,353 (30.7%) as TIR. Substantial non-triptan acute use was observed among TIR patients over the 24-month follow-up period: migraine-related (prescription claim within 15 days of a migraine diagnosis) NSAIDs (48%), opioids (36%), and barbiturates (18%) as well as rimegepant (18%) and ubrogepant (16%). During the first 12 months post-index, a higher proportion of TIR patients had a migraine-related inpatient visit (2.9% vs 0.5%) or emergency department visit (8.4% vs 2.3%) compared to triptan continuers. Mean migraine-related outpatient office visits (3.51 vs 1.96) were also higher in the TIR cohort compared to triptan continuers (P < .01). Adjusted migraine-related total medical costs were $1,800 higher (mean ratio [MR], 3.50 [95% CI, 2.82-3.96]) and prescription costs were $1,158 higher (MR, 3.12 [95% CI, 2.91-3.35]) during the first 12-months post-index in the TIR cohort compared with triptan continuers. Similar patterns in HCRU and cost were observed in months 13-24 of follow-up.

Conclusions When compared with triptan continuers, those with a potential insufficient response to triptans incurred significantly higher total migraine related and medication-related 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.
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.
Amanda Howarth	Miss Howarth has nothing to disclose.
Lauren Wilson	Lauren Wilson has nothing to disclose.
Amit Bodhani, Other (Abbvie)	Mr. Bodhani has received personal compensation for serving as an employee of AbbVie. Mr. Bodhani has stock in AbbVie.
Molly Duan (Abbvie)	Molly Duan has received personal compensation for serving as an employee of 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.

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