Real‐World Economic Impact of OnabotulinumtoxinA in Patients With Chronic Migraine. Issue 10 (9th October 2014)

• Record Type: Journal Article
• Authors: Rothrock, John F.; Bloudek, Lisa M.; Houle, Timothy T.; Andress‐Rothrock, Diane; Varon, Sepideh F.
• Is Part Of: Headache. Volume 54:Issue 10(2014)
• Page Start: 1565
• Page End: 1573
• Publication Date: 2014-10-09
• Subjects: chronic migraine -- onabotulinumtoxinA -- healthcare resource use -- prophylaxis -- cost‐offset; Headache -- Periodicals; Headache -- Periodicals; 616.8491
• DOI: 10.1111/head.12456
• Languages: English
• ISSNs: 0017-8748

Abstract

Abstract : Objective: To determine whether the utilization of healthcare resources is reduced after chronic migraine patients are treated for 6 months with onabotulinumtoxinA. Background: OnabotulinumtoxinA is indicated for headache prophylaxis in patients with chronic migraine, but its effect on healthcare resource use is unknown. Methods: We analyzed data from an open‐label study of 230 chronic migraine patients refractory to ≥2 oral prophylactics who presented to a headache specialty clinic and who were treated with two cycles of onabotulinumtoxinA. Frequency and cost of migraine‐related healthcare resource use, including visits to emergency departments, urgent care, or hospitalization, were compared for the 6 months before and after initial treatment. Costs were based on publicly available sources. Results: Compared with the 6 months predating initial treatment, patients had 55% fewer emergency department visits (174 vs 385), 59% fewer urgent care visits (61 vs 150), and 57% fewer hospitalizations (19 vs 45) during the 6‐month treatment period ( P < .01 for all). Analysis of treatment‐related costs yielded an average reduction of $1219.33/patient, off‐setting 49.7% of the total estimated cost for 6 months of treatment with onabotulinumtoxinA. Conclusions: Although we are unable to distinguish onabotulinumtoxinA's treatment effect from other potential confounding variables, our analysis showed that severely afflicted, treatment‐refractory patients with chronic migraine experienced a significant cost‐offset through reduced migraine‐related emergency department visits, urgent care visits, and hospitalizations in the 6 months following treatment initiation of onabotulinumtoxinA. Future analyses will assess the longer‐term effect of onabotulinumtoxinA treatment and the potential contribution of regression to the mean.