Antimigraine medication use and associated health care costs in employed patients

Abstract

Migraine is under diagnosed and suboptimally treated in the majority of patients, and also associated with decreased productivity in employees. The objective of this retrospective study is to assess the antimigraine medication use and associated resource utilization in employed patients. Patients with primary diagnosis of migraine or receiving antimigraine prescription drugs were identified from an employer-sponsored health insurance plan in 2010. Medical utilization and health care costs were determined for the year of 2010. Generalized linear regression was applied to evaluate the association between health care costs and the use of antimigraine medications by controlling covariates. Of 465 patients meeting the study criteria, nearly 30% that had migraine diagnosis were prescribed antimigraine medications, and 20% that had migraine diagnosis were not prescribed antimigraine medications. The remaining 50% were prescribed antimigraine medications but did not have migraine diagnosis. Patients with antimigraine medication prescriptions showed lower frequency of emergency department visits than those without antimigraine medication prescriptions. Regression models indicated an increase in migraine-related health care costs by 86% but decreases in all-cause medical costs and total health care costs by 42 and 26%, respectively, in the antimigraine medication use group after adjusting for covariates. Employed patients experienced inadequate pharmacotherapy for migraine treatment. After controlling for covariates, antimigraine prescription drug use was associated with lower total medical utilization and health care costs. Further studies should investigate patient self-reported care and needs to manage headache and develop effective intervention to improve patient quality of life and productivity.

Effectiveness of intravenous Dexamethasone versus Propofol for pain relief in the migraine headache: A prospective double blind randomized clinical trial

“…In a recent study on the health care cost in the patients with migraine headache, it was suggested that 45% of the patients with migraine headache do not receive appropriate treatment. Total health care cost tends to be higher in these patients due to their frequent out-patient and emergency referrals compared to the ones receiving medications regularly, even expensive anti-migraine agents [15]. …”

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

“…More recently, another retrospective analysis of claims from an employer-sponsored health plan found that, after controlling for several covariates, migraine patients who used antimigraine medications had significantly lower migraine-related resource utilization compared with untreated migraine patients. 24 However, the analysis grouped together triptans, ergotamines, and NSAIDs as antimigraine medications. Furthermore, the analysis was entirely cross-sectional, and although regression models were used to control for several covariates, differences between treated and untreated migraine patients are likely to persist.…”

Triptan use among hospital workers affected by migraine

“…Nevertheless, in clinical practice the use of these drugs is less widespread than that of other, less specific drugs, such as non-steroidal antiinflammatory drugs (NSAIDs). Several studies showed that among recognized migraineurs few subjects are submitted to specific treatment [5]. In a recent investigation, only from 0.7 to 1.0 % of the analyzed population on migraine subjects used triptans [6], while in other studies the percentage varied between 3.0 and 19 % [7,8].…”