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Real‐World Economic Impact of Onabotulinumtoxin A in Patients With Chronic Migraine
Author(s) -
Rothrock John F.,
Bloudek Lisa M.,
Houle Timothy T.,
AndressRothrock Diane,
Varon Sepideh F.
Publication year - 2014
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 - 10.1111/head.12456
Subject(s) - medicine , migraine , emergency department , chronic migraine , specialty , emergency medicine , health care , refractory (planetary science) , confounding , physical therapy , anesthesia , psychiatry , physics , astrobiology , economics , economic growth
Objective To determine whether the utilization of healthcare resources is reduced after chronic migraine patients are treated for 6 months with onabotulinumtoxin A . Background Onabotulinumtoxin A 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 onabotulinumtoxin A . 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 onabotulinumtoxin A . Conclusions Although we are unable to distinguish onabotulinumtoxin A '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 onabotulinumtoxin A . Future analyses will assess the longer‐term effect of onabotulinumtoxin A treatment and the potential contribution of regression to the mean.