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Abstract Details

Evaluation of Unmet Needs and Quality-of-Care Indicators among Patients with Migraine in the United States: 2021–2022
Headache
P9 - Poster Session 9 (5:00 PM-6:00 PM)
15-007
Assess unmet needs and gaps in migraine care by evaluating demographics, frequency, healthcare resource utilization (HRU), and medication use as quality of care (QOC) indicators.
Migraine is a debilitating headache disorder with substantial unmet need despite therapeutic advances.
Using 2021-2022 Merative® MarketScan claims, adults with continuous enrollment were evaluated. Frequency of episodic, chronic and overall migraine (EM or CM) were assessed through ICD-10 diagnosis codes. Migraine QOC indicators included: (1)migraine-related healthcare visits; (2)medication use: generic and branded acute and preventive medications; (3)other migraine-related diagnoses: acute medication overuse (AMO), medication overuse headache (MOH) for drug-induced headache; and (4)other migraine-related HRU: MRI and CT. 

In 2021 and 2022, 356,395 and 360,182 patients were identified; 83% EM, 17% CM. Most had outpatient visits (97%, mean[SD]:2.3[3.0]) and <3% of patients had ≥1 migraine-related hospitalization or urgent care visit, AMO, or MOH. 21% had migraine-related neurology visits (mean[SD]:0.46[1.2]), and more than half had migraine-related primary care visits (2021: 53%, mean[SD]:0.9[1.3]; 2022: 51%, mean[SD]:0.8[1.3]). 7% had ≥1 migraine-related ED visits. The 30-day readmission rate was 4%. For both years, generic treatment use  was higher than branded therapies respectively. From 2021 to 2022, generic acute treatments declined from 69% (mean[SD]: 3.3 prescriptions[5.0]) to 65% (mean[SD]:3.1 prescriptions[4.8]), branded acute treatments slightly increased from 8% (mean[SD]:0.3[1.4]) to 10% (mean[SD]:0.4[1.6]). Generic oral migraine preventive treatment slightly decreased from 59% (mean[SD]:4.1 prescriptions[5.6]) to 57% (mean[SD]:4.0 prescriptions[5.5]), branded preventive treatment increased from 5% (mean[SD]:0.2[0.8]) to 8% (mean[SD]:0.3[1.3]). slight reduction in barbiturate and opioid use was observed in 2022, with a ~1 in 4 patients reported an opioid fill (26%[2021]; 24%[2022]). 
HRU patterns for outpatient, primary care, neurology, and ED visits, along with acute and preventive medication use reveal gaps and unmet needs in migraine management strategies.  
Authors/Disclosures
Vincent Martin, MD
PRESENTER 		Dr. Martin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Martin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Martin has received research support from Amgen. The institution of Dr. Martin has received research support from Eli Lilly. The institution of Dr. Martin has received research support from Teva. The institution of Dr. Martin has received research support from Abbvie. Dr. Martin has received intellectual property interests from a discovery or technology relating to health care.
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.
Krutika Jariwala-Parikh, PhD (AbbVie) Dr. Jariwala-Parikh has received personal compensation for serving as an employee of AbbVie. Dr. Jariwala-Parikh has stock in AbbVie.
Huiwen Deng, PhD Dr. Deng has received personal compensation for serving as an employee of AbbVie.
Xiaoyu Dong, PhD Dr. Dong has received personal compensation for serving as an employee of UCB.
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.