Costs and Utilization of Triptan Users Who Receive Drug Prophylaxis for Migraine Versus Triptan Users Who Do Not Receive Drug Prophylaxis

Etemad, Lida; Yang, Winnie; Globe, Denise; Barlev, Arie; Johnson, Kathleen A.

doi:10.18553/jmcp.2005.11.2.137

Cited by 35 publications

(58 citation statements)

References 14 publications

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“…[9][10][11][12][13][14][15] The fact that patients who filled their triptan prescriptions only once showed a significant decrease in the rates of physician office visits and diagnostic imaging after their index triptan fill is potentially suggestive of misdiagnosis. If these patients truly suffered from migraines, one would expect their medical services utilization rates to continue increasing on a trajectory similar to or worse than that of patients who frequently switched their triptans The fact that triptans seemed less effective at reducing the utilization of other services and medications among patient who switched triptans frequently is logical if triptan switching is viewed as an indicator of ineffectiveness.…”

Section: Patient Characteristics and Follow-up Time Stratified By Trimentioning

confidence: 99%

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Health Care Resource Utilization Following Initiation of a Triptan: A Retrospective Claims Analysis

Messali

Owens²,

Bloudek³

et al. 2014

JMCP

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Migraine headaches are among the most common neurological disorders in the United States and other Western countries. Eighteen percent of women and 6% of men in the United States above the age of 12 suffer from migraines-roughly 23 million Americans.1 Migraine prevalence is highest among 35 to 45 year olds, Caucasian women, and lower-income households.2 These factors associated with migraine prevalence have been consistently described in research conducted in the United States, Canada, and several European countries. [3][4][5] The direct costs of migraine treatment have been estimated to exceed $1 billion each year. 1,6 About 60% of these direct costs are attributable to physician office visits, and another 30% can be attributed to prescription drug treatment. The remaining 10% consists of inpatient treatment and emergency room visits. As is the case with many chronic diseases, the indirect costs of migraine headaches far outweigh the direct costs. The attributable productivity losses to American employers have been estimated to be roughly $13 billion annually. 1,6 The majority of these productivity losses ($8 billion each year) are the result of migraine-related missed workdays.From a payer's perspective, an important aspect of the value of prescription medications lies in their potential to prevent more costly utilization of health care resources, such as emergency room visits and inpatient hospitalizations, by managing ABSTRACTBACkgRoUnd: 23 million Americans suffer from migraine headaches, incurring more than $1 billion in direct medical costs each year (with another $13 billion in indirect productivity losses). Triptans are the most common treatment of choice for these patients; however, adherence and persistence to triptans are poor. Partly due to poor adherence to therapy, the ability of triptans to reduce the utilization of other medical services and prescription drugs remains unclear.

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Section: Patient Characteristics and Follow-up Time Stratified By Trimentioning

confidence: 99%

“…9,11 The proportion of patients that fill only 1 triptan prescription without any further refills has ranged from 38% to 56%. 9,10,[12][13][14][15] Triptan brand switching is also a common occurrence. Roughly 15% of triptan users will try a new triptan over 1 year of follow-up.…”

mentioning

confidence: 99%

Health Care Resource Utilization Following Initiation of a Triptan: A Retrospective Claims Analysis

Messali

Owens²,

Bloudek³

et al. 2014

JMCP

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“…A retrospective administrative database study was conducted to measure the direct (pharmacy and medical) costs of migraine-related healthcare services in moderate-to-severe migraine patients treated with drug prophylaxis compared with migraine patients who are not treated with drug prophylaxis [12].…”

Section: Prophylactic Treatmentmentioning

confidence: 99%

Risk–benefit and cost–benefit ratio in headache treatment

2005

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IntroductionHeadache disorders are ubiquitous, common, disabling and to a very large extent treatable in primary care. Migraine headaches affect 12% of the adult population worldwide and cause significant economic loss due to decreased workplace productivity. Although interactions between pharmacists and individuals with headache are common, few pharmacists receive adequate training regarding migraine therapy. There are several misconceptions that hinder effective care, such as that migraine is a vascular disease, triptans cause rampant cardiac-related morbidity and even mortality. The last decade's experience with triptans in more than half a billion people worldwide reveals a benign adverse-effect profile, particularly when taken early in an attack. Published reports and real-world experiences illustrate that these drugs do not merit fears of triptan-induced cardiac consequences in appropriately selected individuals. Society's productivity loss due to migraine is measured in billions of dollars. Restoring a patient's ability to function normally is now recognised as the primary treatment goal, not merely relieving pain. Thus, the over-reliance on "pain killer" drugs such as butalbital-containing products and the continued underutilisation of migraine-specific drugs need to be addressed [1]. Attack treatmentOne of the main problems in treating migraine is how to treat attacks. In this situation it has been shown that stratified care is more efficacious and economic than step care strategies [2]. These results were confirmed later and a J Headache Pain (2005) 6:315-318 DOI 10.1007/s10194-005-0219-5 Abstract The cost-benefit and the risk-benefit ratios are two of the most relevant items in ongoing health organisation procedures. The choice of a new or an old therapeutic treatment depends on a number of factors and the evaluation of the cost, in terms of economics, but also in terms of quality of life and type of facilities necessary for one treatment are crucial criteria. Therefore, we have to consider in evaluating treatment strategies not only the activity of a drug in reaching the main endpoints, (i.e., pain free or headache relief) but also the safety and perception of safety by patients, and the cost effectiveness, including indirect costs compared with personal and social benefits. Because it is reasonable that a subgroup of migraine patients may have a clinically progressive disorder, studies should be necessary to assess strategies for migraine treatments. Risk-benefit and cost-benefit ratio in headache treatment H E A D A C H E : T H E R A P E U T I C C H

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“…Two studies of this type recently have examined the relationship between migraine prevention and health care resource utilisation [17,18]. The results suggest that the addition of a preventive medication to an individual's existing treatment for migraine reduced utilisation of abortive prescription medications, physician visits and emergency room visits which resulted in overall cost-savings to the health plans.…”

Section: Introductionmentioning

confidence: 99%

“…However, the results were criticised because of methodological shortcomings in design and implementation of the analysis [19]. In this paper, we build on previous research [17,18] and attempt to address several threats to validity identified in earlier studies. Our objective is to evaluate if initiation of daily migraine prevention has an observable affect on ambulatory health care utilisation compared to acute migraine treatment alone.…”

Section: Introductionmentioning

confidence: 99%

Effect of daily migraine prevention on health care utilisation in an insured patient population

Devine¹,

Hadsall

Cline

et al. 2007

J Headache Pain

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The economic benefits of daily migraine prevention have been subject to ongoing debate. This study was undertaken to determine if the initiation of prevention had an observable effect on ambulatory health care utilisation when compared to acute migraine treatment alone. Administrative claims data from the Military Health System were used to conduct a retrospective, longitudinal cohort study of 3762 patients with migraine. New users of daily migraine prevention were matched to a reference group of non-users using propensity score methods. This matched sample then was used to evaluate the effect of prevention on ambulatory health care expenditures. The study results showed that exposure to daily migraine prevention led to lower rates of utilisation relative to what new patients would have consumed in the absence of treatment. The results suggest that additional economic benefits could be realised by increasing the appropriate use of daily migraine prevention.

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Costs and Utilization of Triptan Users Who Receive Drug Prophylaxis for Migraine Versus Triptan Users Who Do Not Receive Drug Prophylaxis

Cited by 35 publications

References 14 publications

Health Care Resource Utilization Following Initiation of a Triptan: A Retrospective Claims Analysis

Health Care Resource Utilization Following Initiation of a Triptan: A Retrospective Claims Analysis

Risk–benefit and cost–benefit ratio in headache treatment

Effect of daily migraine prevention on health care utilisation in an insured patient population

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