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Cephalalgia. 2016 Aug;36(9):862-74. doi: 10.1177/0333102415621294. Epub 2015 Dec 20.

Comparative effectiveness of onabotulinumtoxinA versus oral migraine prophylactic medications on headache-related resource utilization in the management of chronic migraine: Retrospective analysis of a US-based insurance claims database.

Author information

1
Global Health Economics and Outcomes Research, Allergan plc, USA Hepp_Zsolt@Allergan.com.
2
Headache Center, Hofstra Northshore LIJ, USA.
3
Global Health Economics and Outcomes Research, Allergan plc, USA.
4
Consultant to Allergan plc., USA.
5
Department of Neurology, Mayo Clinic, USA.

Abstract

BACKGROUND:

Migraine, especially chronic migraine (CM), causes substantial disability; however, health care utilization has not been well characterized among patients receiving different migraine prophylactic treatments.

METHODS:

Using a large, US-based, health care claims database, headache-related health care utilization was evaluated among adults with CM treated with onabotulinumtoxinA or oral migraine prophylactic medications (OMPMs). Headache-related health care utilization was assessed at six, nine, and 12 months pre- and post-treatment. The primary endpoint was the difference between pre- and post-index headache-related health care utilization. A logistic regression model was created to test the difference between onabotulinumtoxinA and OMPM-treated groups for headache-related emergency department (ED) visits and hospitalizations.

RESULTS:

Baseline characteristics were comparable between groups. The proportion of patients with ED visits or hospitalizations for a headache-related event decreased after starting onabotulinumtoxinA, but increased after starting an OMPM, for all three cohorts. Regression analyses showed that the odds of having a headache-related ED visit were 21%, 20%, and 19% lower and hospitalization were 47%, 48%, and 56% lower for the onabotulinumtoxinA group compared to the OMPM group for the six-month, nine-month, and 12-month post-index periods, respectively.

CONCLUSIONS:

When compared with similar patients who initiated treatment with OMPM, onabotulinumtoxinA was associated with a significantly lower likelihood of headache-related ED visits and hospitalizations.

KEYWORDS:

Chronic migraine; claims database; emergency department visits; hospitalizations; office visits; onabotulinumtoxinA; out-of-pocket expenses; payer costs; resource utilization

PMID:
26692400
DOI:
10.1177/0333102415621294
[Indexed for MEDLINE]

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