Abstract Details

Title Reduction in Opioid Prescription Fills and Morphine Milligram Equivalent Dispensed Following Initiation of Nurtec ODT Treatment – A Real World Administrative Claims Study

Topic Headache

Presentation(s) S31 - Advances in Migraine Therapeutics (5:18 PM-5:30 PM)

Poster/Presentation
Number 010

Background Due to efficacy and tolerability challenges with currently available therapies, many migraine patients resort to non-targeted abortive or palliative therapies, which, by themselves or in combination with front-line therapies such as triptans, increase the risk of adverse effects such as medication overuse headache (MOH) and, in the case of opioids, carry a risk of dependence, which is a public-health concern. Understanding patterns of opioid use in migraine patients in the context of novel targeted therapies like Nurtec ODT is therefore of clinical and epidemiological interest.

Objective To characterize and quantify opioid use in migraine patients who have used opioids prior to initiating migraine therapy with Nurtec ODT.

Design/Methods Prescription claims data from 6/15/2019 to 7/31/2021 was collected from a large longitudinal pharmacy commercial claims database for 280,773 migraine patients treated with Nurtec ODT. We required 18 months of total follow-up, time aligned with Nurtec Initiation (NI) at the midpoint, at least two Nurtec ODT fills, and at least one opioid fill in the 9-month pre-NI baseline period for study eligibility. For the 14,109 eligible patients, opioid prescription fill counts, quantities dispensed, and morphine milligram equivalents (MME) dispensed were computed. Triptan exposure in the pre-RI baseline period was noted and sensitivity analysis was performed on the 6,579 eligible patients with no triptan exposure pre-RI.

Results We observe a 16.06% decrease in total opioid Rx fills and a 2.84% decrease in mean monthly MME dispensed post-NI, with mean monthly MME dispensed trending upward pre-NI and downward post-NI (n=14,019). These effects were similar in direction but smaller in magnitude for patients with no triptan exposure pre-NI: -15.23% fills and -1.72% mean monthly MME dispensed (n=6,579).

Conclusions A significant decrease in opioid use, measured by mean monthly fills and mean monthly MME dispensed, was observed in the months following initiation of rimegepant therapy.

Authors/Disclosures
Noah Rosen, MD, FAAN PRESENTER	Dr. Rosen has received personal compensation for serving as an employee of Northwell Health. An immediate family member of Dr. Rosen has received personal compensation for serving as an employee of New York University. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer . Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Speaker with American Headache Society.
Ali Mohajer, PhD (Qral Group)	Dr. Mohajer has received personal compensation for serving as an employee of Qral Group, LLC.
	No disclosure on file
Gilbert J. L'Italien	Gilbert J. L'Italien has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Gilbert J. L'Italien has stock in biohaven pharmaceuticals.
Linda Harris, MPH (Biohaven Pharmaceuticals)	Ms. Harris has received personal compensation for serving as an employee of Biohaven Pharmaceuticals. Ms. Harris has received stock or an ownership interest from Biohaven Pharmaceuticals.
Vladimir Coric	Vladimir Coric has received personal compensation for serving as an employee of Biohaven. Vladimir Coric has received personal compensation in the range of $1,000,000+ for serving as an officer or member of the Board of Directors for Bioahven. Vladimir Coric has stock in Biohaven. Vladimir Coric has received intellectual property interests from a discovery or technology relating to health care.