Studies Compare the Burdens of Chronic and Episodic Migraine

Migraine, including the chronic migraine (CM) and episodic migraine (EM), is a common neurologic disease that affects a large population in the United States. Two recent studies investigated the economic and clinical burdens on patients diagnosed with migraine.

One study compared the 12-month healthcare costs of patients diagnosed with CM to the costs of patients diagnosed with EM. The research used data from a large US health insurer from 2013 to 2016. Each of the samples were patients at least 18 years old with at least 2 migraine diagnoses at least 30 days apart.

The CM group included patients with at least 2 CM diagnoses, while the EM group included patients with at least 2 non-CM migraines without any evidence of CM throughout the full study. The 12-month postindex total included all costs, such as the total cost, medical, and pharmacy costs, and they were compared between the diagnosed CM group and the EM group.

In total, 5555 CM patients and 34,690 EM patients were included in the analysis. The results revealed that CM patients had a significantly greater total direct costs ($22,103) than EM patients ($17,225). The average adjusted medical costs for CM were $17,265 and $14,210 for EM, while for adjusted pharmacy costs they were $4925 for CM and $3011 for EM.

“Diagnosed CM was associated with significantly higher total, medical and prescription costs than the diagnosed EM,” concluded the study. “Appropriate measures are needed to ensure that CM patients are diagnosed and better managed to reduce overall healthcare costs.”

The other study investigated the unmet need of EM and CM patients with failed previous preventives. The research included patients with at least 1 failed prior preventive and evaluated the treatment effect of erenumab—a monoclonal antibody binding calcitonin gene-related peptide (CGRP) receptors.

The analysis created an economic model to predict the mean number of monthly migraine days (MMD) experience by patients who have experienced a failed prior preventive and who are currently being treated with only acute medication.

The results revealed that patients treated only with acute medication were expected to suffer an average of 112.5 average migraine days (MD) for EM patients and 239.5 MD for CM patients, over the course of one year. Additionally, those treated with erenumab were predicted to avoid 39.8 MD and 87.8 MD in EM and CM, respectively, over the year.

“The clinical burden of migraine to individual patients is high, and can be substantially reduced by treatment with erenumab,” concluded the research. “These MMD are associated with substantial costs of medical resource use, acute medication use and lost productivity, as well as impacts on patient functioning and quality of life.”

References

1. Marcus S, Shewale AR, Doshi JA, et al. Economic burden of diagnosed chronic migraine and diagnosed episodic migraine patients in a large US health insurer’s population. Presented at the International Society of Pharmacoeconomic and Outcomes Research Annual International Meeting. May 21, 2018; Baltimore, Maryland. Abstract PND48.

2. Porter JK, Di Tanna GL, Lipton RB, et al. Modeling the reduction in the clinical burden of migraine with erenumab treatment. Presented at the International Society of Pharmacoeconomic and Outcomes Research Annual International Meeting. May 21, 2018; Baltimore, Maryland. Abstract PND28.