Polson Michael, Williams Ted D, Speicher Lindsay C, Mwamburi Mkaya, Staats Peter S, Tenaglia Andrew T
Magellan Method, a Division of Magellan Rx Management, Middletown, RI. Email:
Am J Manag Care. 2020 Feb;26(1 Suppl):S3-S7. doi: 10.37765/ajmc.2020.42543.
This study evaluates the impact of concomitant medical conditions on patients with and without migraine, assessing healthcare utilization, and total cost of care. Medical and pharmacy claims from multiple health plans, both nationally and internationally, were examined to evaluate overall real-world trends in commercially insured patients diagnosed with migraine. A total of 53,608 patients with diagnosis codes for migraine met the study criteria and were matched 1:1 with controls (81.8% female; mean age, 42 years; mean Charlson Comorbidity Index score, 0.34). During the 3-year measurement period, mean medical costs per patient in the migraine cohort were about 1.7 times that of the control group ($22,429 vs $13,166). Unique encounters and cost per patient by medical service type for the migraine cohort compared with the control group were as follows: emergency department, 4.13 ($4000) versus 2.94 ($2639); hospital inpatient, 3.15 ($17,748) versus 2.67 ($16,010); hospital outpatient, 5.14 ($365) versus 4.85 ($396); physician office, 36.78 ($6803) versus 21.39 ($4069); laboratory, 10.12 ($1433) versus 7.71 ($1057); radiology, 7.64 ($2609) versus 5.94 ($1733). Mean pharmacy costs per patient were approximately 1.8 times higher in the migraine cohort compared with the control cohort ($8441 vs $4588, respectively; P <.0001). These results suggest that patients with migraine have more comorbidities compared with those without migraine. These patients also utilize healthcare resources at a significantly higher rate compared with similar patients without a migraine diagnosis. An unmet need exists for new treatment modalities in this patient population. More effective interventions and proper management may lead to improved patient outcomes and healthcare costs for patients with migraine.
本研究评估了合并症对偏头痛患者和非偏头痛患者的影响，评估了医疗保健利用率和护理总成本。研究检查了来自国内和国际多个健康计划的医疗和药房理赔数据，以评估商业保险的偏头痛确诊患者的总体真实世界趋势。共有53608名有偏头痛诊断代码的患者符合研究标准，并与对照组进行1:1匹配（81.8%为女性；平均年龄42岁；平均查尔森合并症指数评分0.34）。在3年的测量期内，偏头痛队列中每位患者的平均医疗费用约为对照组的1.7倍（22429美元对13166美元）。偏头痛队列与对照组相比，按医疗服务类型划分的每位患者的独特就诊次数和费用如下：急诊科，4.13次（4000美元）对2.94次（2639美元）；医院住院，3.15次（17748美元）对2.67次（16010美元）；医院门诊，5.14次（365美元）对4.85次（396美元）；医生办公室，36.78次（6803美元）对21.39次（4069美元）；实验室，10.12次（1433美元）对7.71次（1057美元）；放射科，7.64次（2609美元）对5.94次（1733美元）。偏头痛队列中每位患者的平均药房费用比对照组高出约1.8倍（分别为8441美元对4588美元；P<.0001）。这些结果表明，与非偏头痛患者相比，偏头痛患者有更多的合并症。与未诊断为偏头痛的类似患者相比，这些患者使用医疗保健资源的比率也显著更高。该患者群体对新治疗方式存在未满足的需求。更有效的干预措施和适当的管理可能会改善偏头痛患者的治疗效果和医疗成本。
