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J Med Econ. 2019 Mar 5:1. doi: 10.1080/13696998.2019.1590841. [Epub ahead of print]

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

Author information

1
a CHU Timone , Marseille , France.
2
b CEMKA , Bourg-la-Reine , France.
3
c Novartis Pharma , Rueil-Malmaison , France.
4
d UMS 011 - INSERM, UVSQ , Villejuif , France.
5
e Université Paris-Dauphine, PSL Research University, LEDa [LEGOS] , Paris , France.

Abstract

OBJECTIVES:

To estimate the burden of migraine in the population of French patients identified as specific migraine acute treatment users as compared to a control group.

METHODS:

A cross-sectional retrospective analysis was performed on the "Echantillon Généraliste des Bénéficiaires" claims database, a 1/97 random sample of the French public insurance database. A representative sample of all adults with at least one delivery of triptans, ergot derivatives or acetylsalicylic acid/metoclopramide (all drugs with a Specific label in Migraine Acute Treatment - SMAT) in 2014 was selected with a control group matched on age, gender and geographic region. Among triptan users, a sub-group of over-users was defined according to their level of triptan uptake expressed in Defined Daily Doses (DDD - a standard daily dose of treatment of acute migraine) per month over 3 months and more, was also compared with controls. The cost analysis was performed in a societal perspective for direct costs. Sick leaves indirect costs were estimated using the human capital approach.

RESULTS:

8,639 SMAT users (mean age: 44.6 years; 78.7% of women) were selected representing a crude prevalence rate of 1.7%. The annual per capita total healthcare expenditures were higher by €280 in this group as compared to controls (€2,463 vs €2,183). Triptans contributed for 47.8% to this extra cost. They used significantly (p < 0.0001) more frequently than controls antidepressants (20.8% vs 11.0%), anxiolytics (29.4% vs 18.8%) and analgesics (53.8% vs 35.8%). The per capita annual productivity loss associated with sick leaves were higher by €295 (€1,712 vs €1,417). Among triptan users, there were 2.9% of over-users. This last group was characterized by substantially higher per capita annual extra direct (+ €1,805) and indirect costs (productivity loss +€706) as compared to controls.

CONCLUSIONS:

Due to its high prevalence, migraine costs generate a significant societal burden. The group of over-users concentrates high per capita direct and indirect costs.

KEYWORDS:

France; I10; I13; burden; claims database; cost; migraine; triptans

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