Resource utilization impact of topiramate for migraine prevention in the managed-care setting

• Published in: Current Medical Research and Opinion 2009, Vol.25 (2), p.499-503
• Main Authors: Wertz, Debra A., Quimbo, Ralph M., Yaldo, Avin Z., Rupnow, Marcia F. T.
• Format: Report
• Language: English
• Subjects: Cost; Headache; Migraine prophylaxis; Resource use; Topiramate
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1185/03007990802664199

Objective: To determine the pattern of headache-related resource utilization and costs before and after initiation of preventive migraine treatment with topiramate in a sample of a large managed-care population. Methods: This study was a retrospective, longitudinal, cohort study analysis of medical and pharmacy claims using The HealthCore Integrated Research Network Database. Patients were required to have had at least one pharmacy claim for topiramate between 7/1/00 and 11/30/04, and at least 12 dosage units dispensed of any combination of acute migraine treatments (triptan, ergotamine, or ergotamine combination) during the 6-month period preceding the first pharmacy claim for topiramate (the index date). Headache-related inpatient and outpatient resource utilizations were compared pre-index vs. post-index period 1 (months 1-6) and pre-index vs. post-index period 2 (months 7-12). Statistical analyses included McNemar tests for categorical variables and paired t-tests for continuous variables. Results: A total of 3246 patients met the inclusion criteria. The mean (± SD) age was 44 ± 10 years and 88% were female. From pre- to post-index period 2, outpatient visits significantly decreased by 30% (p