Evaluation of Unmet Needs and Quality-of-Care Indicators among Patients with Migraine in the United States: 2021–2022
Vincent Martin1, Jessica Ailani2, Krutika Parikh3, Huiwen Deng3, Yanan Dong3, Amit Bodhani3, Richard Lipton4
1University of Cincinnati Gardner Neuroscience Institute, 2Medstar Georgetown Neurology, 3AbbVie, Inc., 4Albert Einstein College of Medicine
Objective:
Assess unmet needs and gaps in migraine care by evaluating demographics, frequency, healthcare resource utilization (HRU), and medication use as quality of care (QOC) indicators.
Background:
Migraine is a debilitating headache disorder with substantial unmet need despite therapeutic advances.
Design/Methods:
Using 2021-2022 Merative® MarketScan claims, adults with continuous enrollment were evaluated. Frequency of episodic, chronic and overall migraine (EM or CM) were assessed through ICD-10 diagnosis codes. Migraine QOC indicators included: (1)migraine-related healthcare visits; (2)medication use: generic and branded acute and preventive medications; (3)other migraine-related diagnoses: acute medication overuse (AMO), medication overuse headache (MOH) for drug-induced headache; and (4)other migraine-related HRU: MRI and CT.
Results:
In 2021 and 2022, 356,395 and 360,182 patients were identified; 83% EM, 17% CM. Most had outpatient visits (97%, mean[SD]:2.3[3.0]) and <3% of patients had ≥1 migraine-related hospitalization or urgent care visit, AMO, or MOH. 21% had migraine-related neurology visits (mean[SD]:0.46[1.2]), and more than half had migraine-related primary care visits (2021: 53%, mean[SD]:0.9[1.3]; 2022: 51%, mean[SD]:0.8[1.3]). 7% had ≥1 migraine-related ED visits. The 30-day readmission rate was 4%. For both years, generic treatment use was higher than branded therapies respectively. From 2021 to 2022, generic acute treatments declined from 69% (mean[SD]: 3.3 prescriptions[5.0]) to 65% (mean[SD]:3.1 prescriptions[4.8]), branded acute treatments slightly increased from 8% (mean[SD]:0.3[1.4]) to 10% (mean[SD]:0.4[1.6]). Generic oral migraine preventive treatment slightly decreased from 59% (mean[SD]:4.1 prescriptions[5.6]) to 57% (mean[SD]:4.0 prescriptions[5.5]), branded preventive treatment increased from 5% (mean[SD]:0.2[0.8]) to 8% (mean[SD]:0.3[1.3]). slight reduction in barbiturate and opioid use was observed in 2022, with a ~1 in 4 patients reported an opioid fill (26%[2021]; 24%[2022]).
Conclusions:
HRU patterns for outpatient, primary care, neurology, and ED visits, along with acute and preventive medication use reveal gaps and unmet needs in migraine management strategies.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.