ABSTRACT
Objective: To characterize healthcare utilization (HCU) and associated costs among patients with migraine categorized by the number of preventive treatment failures (TFs; 1TF, 2TFs, 3+TFs) using real-world data.
Methods: This retrospective analysis identified adults with incident migraine diagnosis in the IBM MarketScan® Commercial and Medicare Supplemental database between January 1, 2011, and June 30, 2015. TF was defined in the 2 years after the first migraine diagnosis period. 1TF, 2TFs, and 3+TFs were defined as patients who had received only two preventive treatments (PTs), three PTs, and 4+ PTs in the 2-year period, respectively. A negative binomial model was used to analyze HCU data, and a two-part model was used for cost data controlling for the pre-index Deyo-Charlson Comorbidity Index.
Results: Overall, 24,282 patients with incident migraine who had failed at least one PT were included in the analysis. Of these, 72.7% (n=17,653) had 1TF, 20.2% (n=4,900) had 2TFs, and 7.1% (n=1,729) had 3+TFs. Adjusted annualized rates of all-cause and migraine-specific HCU increased with an increase in the number of TFs (1.4–4 times higher; all p < 0.0001 vs 1TF). The mean total all-cause healthcare costs were higher by $3,732 (95% confidence interval [CI]: $2,708–$4,588) in patients with 2TFs and by $8,912 (95% CI: $7,141–$10,822) in patients with 3+TFs vs those with 1TF. Outpatient costs were the key drivers of differences in healthcare costs.
Conclusions: TF in patients with migraine was associated with a substantial resource and cost burden, which increased with the number of TFs.
- Received November 20, 2020.
- Accepted February 23, 2021.
- © 2021 American Academy of Neurology
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