Patients with likely undiagnosed chronic migraine had a higher economic burden and more opioid and acute treatment prescriptions compared with patient with diagnosed chronic or episodic migraine, according to a study in the Journal of Managed Care & Specialty Pharmacy.
“Migraine is associated with substantial disability, economic burden, productivity loss, and reduced quality of life,” researchers wrote. “Real-world data on the economic burden and treatment patterns among episodic migraine patients and chronic migraine patients, in particular potentially undiagnosed chronic migraine, is limited.”
To shed some light on costs and treatments among patients with migraine, researchers looked at claims retrospectively for adults with a migraine diagnosis at a large medical practice. Among participants, 182 had likely undiagnosed chronic migraine, defined as having a prior migraine diagnosis, but having neither a chronic migraine diagnosis nor migraine-related onabotulinumtoxinA claim, and identified by a claims-based algorithm as having chronic migraine. Some 161 participants had diagnosed chronic migraine, and 178 had episodic migraine, which was defined as having a prior migraine diagnosis and algorithm identification as not having chronic migraine.
Patients with undiagnosed chronic migraine had mean annual costs of $18,552 over 12 months compared with $16,692 for patients with diagnosed chronic migraine and $6649 for patients with episodic migraine, according to the study.
Nearly 90% of patients with diagnosed and undiagnosed migraine received preventive treatments compared with 55.6% of patients with episodic migraine. Among patients with undiagnosed chronic migraine, 84.6% received acute treatments and 68.7% received opioids, compared with 70.2% and 41% of patients with diagnosed chronic migraine and 75.8% and 34.3% of patients with episodic migraine, researchers reported.
The average number of opioid claims over 12 months was 4.5 among patients with undiagnosed chronic migraine, compared with 2.9 opioid claims for patients with diagnosed chronic migraine and 1.1 for patients with episodic migraine, the study found.
“Improved identification of chronic migraine patients and optimal management of migraine patients, especially undiagnosed chronic migraine patients, is essential,” researchers wrote.
The study, which was sponsored by the pharmaceutical company Allergan, was presented at AMCP Nexus 2018.
Pavlovic J, Yu J, Silberstein S, et al. Economic burden, migraine treatment patterns, and opioid utilization among potentially undiagnosed chronic migraine, diagnosed chronic, and diagnosed episodic migraine patients in a large medical group. Journal of Managed Care & Specialty Pharmacy. 2018;24(10-a):S55.