Abstract Details

Title Relative Frequency, Healthcare Resource Utilization, and Costs of Diagnosed Drug-Induced Headache and Potential Acute Medication Overuse in Patients With Migraine

Topic Headache

Presentation(s) S4 - Hot Topics in Headache Medicine (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Background Limited data exist on the economic burden of medication overuse among patients with migraine.

Objective To estimate a) annual all-cause healthcare resource utilization (HRU) and costs and b) annual migraine-related HRU and costs associated with drug-induced headache (DIH) and with potential acute medication overuse (AMO) among commercially insured migraine patients.

Design/Methods Adult migraine patients with 12 months continuous enrollment for prescription and medical benefits in 2019 were identified based on >1 inpatient claim OR >2 outpatient claims on different dates with diagnosis of migraine (ICD-10-CM code G43.xxx) in any position between 1/1/2019-12/31/2019. Patients with ICD-10-CM code G44.41/40 (drug-induced headache) were diagnosed DIH patients and those with medication overuse for >6 consecutive months (potential AMO patients) were identified. Medication overuse was defined as >10 mean cumulative therapy days/month for ergots, triptans, opioids, and combination analgesics or >15 mean cumulative days/month for simple analgesics, including paracetamol, aspirin, nonsteroidal anti-inflammatory drugs, and other non-opioid analgesics.

Results Among 90,017 migraine patients, the relative frequency of diagnosed DIH was 0.6% and potential AMO occurred in 12.1%. The most commonly overused medications in potential AMO patients were combination analgesics (45.6%), opioids (37.2%), and non-opioid analgesics (22.8%). Adjusted migraine-related total costs were higher in the DIH/AMO cohort ($9770) versus the non-DIH/AMO cohort ($6207), with a significant difference of $3563 (P<0.001). Adjusted all-cause total costs were higher in the DIH/AMO cohort ($31,235) versus the non-DIH/AMO cohort ($21,486), with a significant difference of $9749 (P<0.001). All-cause and migraine-related HRU also were higher in the DIH/AMO cohort.

Conclusions About 1 in 8 patients with migraine had diagnosed DIH or potential AMO, which was associated with high migraine-related total costs and migraine-related HRU compared with patients without evidence of DIH/AMO. Our findings suggest that improved migraine management is needed to reduce associated costs in this population.

Authors/Disclosures
Krutika Jariwala-Parikh, PhD (AbbVie) PRESENTER	Dr. Jariwala-Parikh has received personal compensation for serving as an employee of AbbVie. Dr. Jariwala-Parikh has stock in AbbVie.
Anand R. Shewale (AbbVie)	Anand R. Shewale has received personal compensation for serving as an employee of AbbVie. Anand R. Shewale has stock in AbbVie.
	No disclosure on file
	No disclosure on file
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
	No disclosure on file