Journal of medical economics | 2021
Real-world migraine-related healthcare resource utilization and costs associated with improved vs. worsened/stable migraine: a panel-based chart review in France, Germany, Italy, and Spain.
OBJECTIVE\nTo estimate the migraine-related healthcare resource utilization (HRU) and costs among patients with improved vs. worsened/stable migraine.\n\n\nMETHODS\nThis was a follow-up to a retrospective, panel-based chart review conducted in France, Germany, Italy, and Spain among a panel of physicians (neurologists, headache specialists, and pain specialists) who agreed to participate in patient studies and had treated ≥10 migraine patients in 2017. Eligible physicians extracted data for up to five adults with ≥4 monthly migraine days (MMDs) who initiated a preventive treatment on or after January 1, 2013, and received physician care for ≥6 months after the date of the most recent preventive treatment initiation (index date). Based on the trajectory of migraine severity from the 1-month pre-index period to the 6-month post-index period, cohorts were classified as improved (converting from chronic to episodic or from chronic/episodic to <4 MMDs) or stable/worsened (remaining chronic/episodic or transforming from episodic to chronic) migraine. Migraine-related HRU and costs (2017 €) during the 6-month post-index period were compared between patients with improved versus stable/worsened migraine.\n\n\nRESULTS\nOverall, 470 patient charts were analyzed, with 339 classified as improved migraine and 131 classified as stable/worsened migraine. After adjusting for within-physician correlation, country, sex, and presence of comorbidities before the index date, the improved migraine cohort had significantly fewer migraine-related physician office visits (-0.81; p\u2009<\u20090.001), emergency room/accident & emergency (ER/A&E) visits (-0.67; p\u2009<\u20090.001), and hospitalizations (-0.12; p\u2009<\u20090.001) in the 6-month post-index period versus the stable/worsened migraine cohort. Consistent with HRU patterns, the adjusted migraine-related costs for physician office visits (-€42.23; p\u2009<\u20090.05), hospitalizations (-€215.56; p\u2009<\u20090.05), and total costs (-€396.81; p\u2009<\u20090.01) in the 6-month post-index period were significantly reduced for the improved migraine cohort versus the stable/worsened migraine cohort.\n\n\nCONCLUSIONS\nOver a 6-month period following initiation of preventive migraine treatment, patients with improved migraine had significantly lower migraine-related HRU and costs than those with stable/worsened migraine.