Migraine burden and costs in France: a nationwide claims database analysis of triptan users

Donnet, Anne; Émery, C.; Aly, S; Allaf, Bashar; Cayre, Fanny; Mahieu, N; Gourmelen, J.; Lévy, Pierre; Fagnani, Francis

doi:10.1080/13696998.2019.1590841

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…Furthermore, the personal identification number allowed the linkage to the hospitalization database, enabling us to identify precisely acute vascular events by using previously used and validated ICD codes. The large older population identified in this study is concordant with epidemiological studies showing that older patients could represent 5-8% of the population of triptan users [12,36]. Although migraine is less prevalent in older than in younger age groups, the absolute increase in the total number of older age groups may lead to an increase in the total number of migraine patients [3,37].…”

Section: Discussionsupporting

confidence: 86%

Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events

Tran,

Lapeyre-Mestre,

Berangere

et al. 2024

J Headache Pain

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Background Several studies have focused on the use of triptan and the risk of acute vascular events but the existence of such association is still debated and has never been quantified in patients over 65 years. To assess whether triptan use among older is associated with an increased risk of hospitalization for acute vascular events. Methods A propensity score-matched cohort study was designed using the French national health insurance database linked to hospital stays. Patients aged ≥ 65 years, newly treated by triptans between 2011 and 2014, were included… The primary event was hospitalization for an acute ischemic vascular event within de 90 days following triptan initiation. Association with triptan exposure was investigated through cox regression model, considering exposure at inclusion, and with exposure as a time-varying variable A case-crossover (CCO) and a self-controlled case series (SCCS) analyses were also conducted to address potential residual confounding. Results The cohort included 24, 774 triptan users and 99 096 propensity matched controls (mean (SD) age: 71 years (5.9), 74% of women). Within 90 days after cohort entry, 163 events were observed in the triptan group, and 523 in the control group (0.66% vs. 0.53%, adjusted hazard ratio (aHR) exposed/not exposed 1.25 95%CI [1.05–1.49]; aHR time−varying 8.74 [5.21–14.66]). The association was significant (CCO) for all events (adjusted odds ratio (aOR1.63 [1.22–2.19]) with a more consistent association with cerebral events (aOR 2.14 [1.26–3.63]). The relative incidence (RI) for all events was 2.13 [1.76–2.58] in the SCCS, for cardiac (RI: 1.67 [1.23–2.27]) and for cerebral events (RI: 3.20, [2.30–4.45]). Conclusion The incidence of acute vascular events was low among triptan users. We found that triptan use among older may be associated with a low increased risk for acute vascular events, which may be more marked for cerebral events such as stroke, than for cardiac events.

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Section: Discussionsupporting

confidence: 86%

Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events

Tran,

Lapeyre-Mestre,

Berangere

et al. 2024

J Headache Pain

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“…Paracetamol alone or in combination was mentioned from 81 posts-7284 posts in all countries with a higher proportion in Japan and France, which is in line with a French study that found that the majority (7.5%) of sufferers were using paracetamol alone or in combinations for managing their headache and migraine [47]. The use of analgesics for headache and migraine is very common, and many countries recommend using these as over-the-counter treatment [48][49][50][51]. In contrast to other infodemiology studies, our study gathered additional data on "nonpharmaceutical and medicinal treatments" used by the headache and migraine sufferers in all countries.…”

Section: Comparison With Previous Worksupporting

confidence: 58%

Social Media Listening and Digital Profiling Study of People With Headache and Migraine: Retrospective Infodemiology Study

Goadsby¹,

Torre²,

Constantin³

et al. 2023

J Med Internet Res

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Background There is an unmet need for a better understanding and management of headache, particularly migraine, beyond specialist centers, which may be facilitated using digital technology. Objective The objective of this study was to identify where, when, and how people with headache and migraine describe their symptoms and the nonpharmaceutical and medicinal treatments used as indicated on social media. Methods Social media sources, including Twitter, web-based forums, blogs, YouTube, and review sites, were searched using a predefined search string related to headache and migraine. The real-time data from social media posts were collected retrospectively for a 1-year period from January 1, 2018, to December 31, 2018 (Japan), or a 2-year period from January 1, 2017, to December 31, 2018 (Germany and France). The data were analyzed after collection, using content analysis and audience profiling. Results A total of 3,509,828 social media posts related to headache and migraine were obtained from Japan in 1 year and 146,257 and 306,787 posts from Germany and France, respectively, in 2 years. Among social media sites, Twitter was the most used platform across these countries. Japanese sufferers used specific terminology, such as “tension headaches” or “cluster headaches” (36%), whereas French sufferers even mentioned specific migraine types, such as ocular (7%) and aura (2%). The most detailed posts on headache or migraine were from Germany. The French sufferers explicitly mentioned “headache or migraine attacks” in the “evening (41%) or morning (38%),” whereas Japanese mentioned “morning (48%) or night (27%)” and German sufferers mentioned “evening (22%) or night (41%).” The use of “generic terms” such as medicine, tablet, and pill were prevalent. The most discussed drugs were ibuprofen and naproxen combination (43%) in Japan; ibuprofen (29%) in Germany; and acetylsalicylic acid, paracetamol, and caffeine combination (75%) in France. The top 3 nonpharmaceutical treatments are hydration, caffeinated beverages, and relaxation methods. Of the sufferers, 44% were between 18 and 24 years of age. Conclusions In this digital era, social media listening studies present an opportunity to provide unguided, self-reported, sufferers’ perceptions in the real world. The generation of social media evidence requires appropriate methodology to translate data into scientific information and relevant medical insights. This social media listening study showed country-specific differences in headache and migraine symptoms experienced and in the times of the day and treatments used. Furthermore, this study highlighted the prevalence of social media usage by younger sufferers compared to that by older sufferers.

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“…Third, it is important to take into account that some differences in the mean and median costs might be explained by the level of triptan use. There has been shown that a small group of migraine patients use a lot of triptans which increases the risk of medicine overuse headache and thus results in higher cost among over‐users . Forth, our cost data may be slightly underestimated since a small proportion of all claims (about 3% according internal analysis) were not directly reimbursed by the health insurer but paid out‐of‐pocket by patients.…”

Section: Discussionmentioning

confidence: 89%

“…There has been shown that a small group of migraine patients use a lot of triptans which increases the risk of medicine overuse headache and thus results in higher cost among over-users. 44 Forth, our cost data may be slightly underestimated since a small proportion of all claims (about 3% according internal analysis) were not directly reimbursed by the health insurer but paid out-of-pocket by patients. Finally, our study population is only approximately, but not entirely representative of the general Swiss population, since a slightly higher percentage of elderly patients than in the entire population were included.…”

Section: Discussionmentioning

confidence: 93%

Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

Huber

Agosti

Näpflin

et al. 2019

Pharmacoepidemiology and Drug

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Purpose In course of the new migraine drug development on the global market it is important to quantify the current burden of migraine medication. This study aimed to estimate the comorbidity burden and its relation to healthcare costs in patients using triptans in Switzerland by analyzing a large population‐based database. Methods This retrospective cohort study was based on Swiss health insurance claims data (2015/2016). The study sample comprised adult patients with ≥1 triptan prescription in 2015. We evaluated pharmaceutically treated comorbid conditions (CCs) and costs (12 months after index prescription) of patients using triptan. Multivariable linear regression models with log‐transformed outcomes were performed to identify the factors related to healthcare costs. Results From a total of 749 092, we identified 10,090 patients using triptans (1‐year prevalence of 1.35%), whereas 58.9% had ≥2 CCs. The most frequent CCs were pain‐ and rheumatologic‐related diseases and psychological disorders. Among triptan users, the mean total healthcare costs were highest in older patients with ≥2 CCs (>64 years: migraine with ≥2 CC “12 331 SFr”). Multivariate regression analyses showed that psychological disorders had the strongest impact on healthcare costs (Coefficient: 1.29; 95%‐CI: 1.27‐1.31). Conclusions The present study provides an overview of comorbidities and its related costs in migraine patients, which helps to quantify the current burden of migraine. This is relevant as the recently licensed CGRP antagonists are likely to change current treatment schemes for migraine, which strongly depends also on the comorbidities. The present study might therefore be helpful for the future development of treatment guidelines.

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Migraine burden and costs in France: a nationwide claims database analysis of triptan users

Cited by 7 publications

References 38 publications

Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events

Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events

Social Media Listening and Digital Profiling Study of People With Headache and Migraine: Retrospective Infodemiology Study

Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

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