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Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States

BACKGROUND: Limited data are available on health care resource utilization (HCRU) and health care costs of calcitonin gene–related peptide monoclonal antibodies (CGRP mAbs) for preventive treatment of migraine. OBJECTIVE: To compare all-cause and migraine-related HCRU and direct health care costs in...

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Autores principales: Varnado, Oralee J, Manjelievskaia, Janna, Ye, Wenyu, Perry, Allison, Schuh, Kory, Wenzel, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373045/
https://www.ncbi.nlm.nih.gov/pubmed/35876297
http://dx.doi.org/10.18553/jmcp.2022.28.8.818
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author Varnado, Oralee J
Manjelievskaia, Janna
Ye, Wenyu
Perry, Allison
Schuh, Kory
Wenzel, Richard
author_facet Varnado, Oralee J
Manjelievskaia, Janna
Ye, Wenyu
Perry, Allison
Schuh, Kory
Wenzel, Richard
author_sort Varnado, Oralee J
collection PubMed
description BACKGROUND: Limited data are available on health care resource utilization (HCRU) and health care costs of calcitonin gene–related peptide monoclonal antibodies (CGRP mAbs) for preventive treatment of migraine. OBJECTIVE: To compare all-cause and migraine-related HCRU and direct health care costs in patients with migraine initiating CGRP mAbs, galcanezumab (GMB), vs standard-of-care (SOC) preventive treatments in the United States. METHODS: This retrospective observational study used insurance claims data collected from IBM MarketScan Research Databases. Adults (aged ≥ 18 years) with 1 or more claims for CGRP mAb (GMB, erenumab, or fremanezumab) or SOC preventive treatment between May 1, 2018, and June 30, 2019, were included. The date of earliest migraine treatment claim during this period was the index date. Annual all-cause and migraine-related HCRU included inpatient visits, emergency department visits, and acute and preventive migraine medication fills. After matching, HCRU and costs at 6- and 12-month follow-up in CGRP mAb, specifically GMB, vs SOC cohorts were analyzed using paired t-test and chi-square test. RESULTS: In the 12-month follow-up study, 4,528 patients using CGRP mAb (GMB, n = 426) and 10,897 patients using SOC were included. After matching, 3,082 pairs were identified in the CGRP mAb and SOC cohorts and 421 pairs in the GMB and SOC cohorts. After matching, all variables were well balanced across cohorts. At 12-month follow-up, the percentage decrease in acute and preventive migraine medication fills was significantly greater in the CGRP mAb (acute: −1.5% vs −0.2%, P < 0.001; preventive: −1.1% vs 3.8, P < 0.001) and GMB cohorts (acute: −1.5% vs −0.2%, P = 0.002; preventive: −1.8 vs 3.0, P < 0.001) compared with the SOC cohort. At follow-up, compared with the SOC cohort, the mean change of annual all-cause total costs was significantly higher in both the CGRP mAb ($6,043 vs $1,323, P < 0.001) and GMB cohorts ($8,398 vs $68, P < 0.001), and the mean change of annual migraine-related total costs was significantly higher in both the CGRP mAb ($3,416 vs $976, P < 0.001) and GMB cohorts ($4,334 vs $1,245, P < 0.001). Significant cost savings in mean acute and preventive migraine prescription costs occurred in both the CGRP mAb (acute: −$358 vs −$80, P < 0.001; preventive: −$298 vs $1,376, P < 0.001) and GMB cohorts (acute: −$280 vs −$36, P = 0.034; preventive: −$374 vs $1,537, P < 0.001) compared with the SOC cohort. CONCLUSIONS: Although treatment with CGRP mAbs and GMB increase total costs, they may lead to significantly greater cost savings in outpatient acute and preventive migraine medication costs vs SOC. Further studies assessing indirect health care costs are important to understand additional cost savings with CGRP mAbs.
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spelling pubmed-103730452023-07-31 Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States Varnado, Oralee J Manjelievskaia, Janna Ye, Wenyu Perry, Allison Schuh, Kory Wenzel, Richard J Manag Care Spec Pharm Research BACKGROUND: Limited data are available on health care resource utilization (HCRU) and health care costs of calcitonin gene–related peptide monoclonal antibodies (CGRP mAbs) for preventive treatment of migraine. OBJECTIVE: To compare all-cause and migraine-related HCRU and direct health care costs in patients with migraine initiating CGRP mAbs, galcanezumab (GMB), vs standard-of-care (SOC) preventive treatments in the United States. METHODS: This retrospective observational study used insurance claims data collected from IBM MarketScan Research Databases. Adults (aged ≥ 18 years) with 1 or more claims for CGRP mAb (GMB, erenumab, or fremanezumab) or SOC preventive treatment between May 1, 2018, and June 30, 2019, were included. The date of earliest migraine treatment claim during this period was the index date. Annual all-cause and migraine-related HCRU included inpatient visits, emergency department visits, and acute and preventive migraine medication fills. After matching, HCRU and costs at 6- and 12-month follow-up in CGRP mAb, specifically GMB, vs SOC cohorts were analyzed using paired t-test and chi-square test. RESULTS: In the 12-month follow-up study, 4,528 patients using CGRP mAb (GMB, n = 426) and 10,897 patients using SOC were included. After matching, 3,082 pairs were identified in the CGRP mAb and SOC cohorts and 421 pairs in the GMB and SOC cohorts. After matching, all variables were well balanced across cohorts. At 12-month follow-up, the percentage decrease in acute and preventive migraine medication fills was significantly greater in the CGRP mAb (acute: −1.5% vs −0.2%, P < 0.001; preventive: −1.1% vs 3.8, P < 0.001) and GMB cohorts (acute: −1.5% vs −0.2%, P = 0.002; preventive: −1.8 vs 3.0, P < 0.001) compared with the SOC cohort. At follow-up, compared with the SOC cohort, the mean change of annual all-cause total costs was significantly higher in both the CGRP mAb ($6,043 vs $1,323, P < 0.001) and GMB cohorts ($8,398 vs $68, P < 0.001), and the mean change of annual migraine-related total costs was significantly higher in both the CGRP mAb ($3,416 vs $976, P < 0.001) and GMB cohorts ($4,334 vs $1,245, P < 0.001). Significant cost savings in mean acute and preventive migraine prescription costs occurred in both the CGRP mAb (acute: −$358 vs −$80, P < 0.001; preventive: −$298 vs $1,376, P < 0.001) and GMB cohorts (acute: −$280 vs −$36, P = 0.034; preventive: −$374 vs $1,537, P < 0.001) compared with the SOC cohort. CONCLUSIONS: Although treatment with CGRP mAbs and GMB increase total costs, they may lead to significantly greater cost savings in outpatient acute and preventive migraine medication costs vs SOC. Further studies assessing indirect health care costs are important to understand additional cost savings with CGRP mAbs. Academy of Managed Care Pharmacy 2022-08 /pmc/articles/PMC10373045/ /pubmed/35876297 http://dx.doi.org/10.18553/jmcp.2022.28.8.818 Text en Copyright © 2022, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Research
Varnado, Oralee J
Manjelievskaia, Janna
Ye, Wenyu
Perry, Allison
Schuh, Kory
Wenzel, Richard
Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States
title Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States
title_full Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States
title_fullStr Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States
title_full_unstemmed Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States
title_short Health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the United States
title_sort health care resource utilization and costs associated with treatment among patients initiating calcitonin gene–related peptide inhibitors vs other preventive migraine treatments in the united states
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373045/
https://www.ncbi.nlm.nih.gov/pubmed/35876297
http://dx.doi.org/10.18553/jmcp.2022.28.8.818
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