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Impact of Chest Pain on Cost of Migraine Treatment With Almotriptan and Sumatriptan
Author(s) -
Wang Joseph T.,
Barr Charles E.,
Goldfarb Scott D.
Publication year - 2002
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1046/j.1526-4610.2002.0420s1038.x
Subject(s) - sumatriptan , medicine , triptans , migraine , chest pain , emergency medicine , cohort , medical diagnosis , population , anesthesia , physical therapy , surgery , radiology , receptor , environmental health , agonist
Chest‐related symptoms occur with all triptans; up to 41% of patients with migraine who receive sumatriptan experience chest symptoms, and 10% of patients discontinue treatment. Thus, the cost of chest pain‐related care was estimated in migraineurs receiving almotriptan 12.5 mg versus sumatriptan 50 mg. A population‐based, retrospective cohort study used data to quantify the incidence and costs of chest pain‐related diagnoses and procedures. An economic model was constructed to estimate annual cost savings per 1000 patients receiving almotriptan versus sumatriptan based on the reported rates of chest pain. Annual direct medical cost avoided was calculated for a hypothetical health plan covering 1 million lives. Among a cohort of 1390 patients, the incidence of chest pain‐related diagnoses increased significantly by 43.6% with sumatriptan ( P =.003). Aggregate costs for chest pain‐related diagnoses and procedures increased from $22 713 to $30 234. Payments for inpatient hospital services, costs for primary care visits, and costs for outpatient hospital visits increased by over 100%, 53.1%, and 14.4%, respectively. The model predicted $11 215 in direct medical cost savings annually per 1000 patients treated with almotriptan versus sumatriptan. Annual direct medical costs avoided totaled $194 358, and when applied to recent estimates of 86 million lives currently covered by almotriptan treatment, translates into an annual cost savings of just under $17 million for chest pain and associated care. Thus, using almotriptan in place of sumatriptan will likely reduce the cost of chest pain‐related care.