Chandler David, Szekely Christine, Aggarwal Shivani, Cyprien Lori, Bensink Mark
Global Health Economics, Amgen Inc., 1 Amgen Center Dr, Thousand Oaks, CA, 91320, USA.
Center for Observational Research, Amgen Inc., Thousand Oaks, CA, USA.
Pain Ther. 2021 Dec;10(2):1551-1566. doi: 10.1007/s40122-021-00319-z. Epub 2021 Sep 17.
Erenumab is indicated for migraine preventive treatment in adults. The objective of this study was to provide descriptive information on real-world use of erenumab including patient profile and treatment patterns.
We completed a retrospective review of US data (through May 2019) from the IBM MarketScan Early View Databases, identifying adult patients newly treated with erenumab with a migraine claim in the year prior to first erenumab claim (index) and at least 1 year of continuous pre-index medical and pharmacy insurance coverage, to assess pre- and post-erenumab migraine characteristics, comorbidities, healthcare resource utilization, and associated costs. All data were summarized using descriptive statistics.
A total of 9753 patients met inclusion criteria. The average (SD) age was 46 (12) years, 85% of patients were female, and 64% had at least one claim for chronic migraine; 70% of erenumab users had an initial dose of 70 mg; 77% of patients in the 6-month follow-up sample (n = 4437) remained on their initial erenumab dose. Persistence at 6-month follow-up was 47.3% with a mean (95% CI) proportion of days covered of 0.68 (0.67, 0.68). In the post-erenumab period, claims for comorbidities of non-migraine headaches and anxiety were reduced and there was a shift to decreased use of acute and preventive medications. Reductions in overall use and associated cost of healthcare resources such as inpatient hospitalization and outpatient office visits were minimal, with slightly more pronounced reductions in the subgroup of patients that were persistent to erenumab.
We observed reductions in claims for important migraine characteristics, comorbidities, and a shift to decreased use of acute and preventive migraine medications-observations indicative of the real-world effectiveness of erenumab. Further examination is required as persistence to erenumab, which may be influenced by dose titration, appears to be an important factor in changes to healthcare resource utilization and costs.
erenumab适用于成人偏头痛的预防性治疗。本研究的目的是提供关于erenumab实际应用的描述性信息，包括患者概况和治疗模式。
我们对来自IBM MarketScan早期视图数据库的美国数据（截至2019年5月）进行了回顾性审查，确定在首次使用erenumab索赔（索引）前一年有偏头痛索赔且在索引前至少有1年连续医疗和药房保险覆盖的成年患者，以评估使用erenumab前后的偏头痛特征、合并症、医疗资源利用情况及相关成本。所有数据均使用描述性统计进行汇总。
共有9753名患者符合纳入标准。平均（标准差）年龄为46（12）岁，85%的患者为女性，64%的患者至少有一次慢性偏头痛索赔；70%的erenumab使用者初始剂量为70mg；6个月随访样本（n = 4437）中的77%患者仍使用初始erenumab剂量。6个月随访时的持续率为47.3%，平均（95%置信区间）覆盖天数比例为0.68（0.67，0.68）。在使用erenumab后，非偏头痛性头痛和焦虑症合并症的索赔减少，急性和预防性药物的使用也有所减少。住院和门诊就诊等医疗资源的总体使用和相关成本的降低幅度很小，在持续使用erenumab的患者亚组中降低幅度稍大。
我们观察到重要偏头痛特征、合并症的索赔减少，急性和预防性偏头痛药物的使用也有所减少，这些观察结果表明erenumab在实际应用中的有效性。由于对erenumab的持续使用可能受剂量滴定影响，而这似乎是医疗资源利用和成本变化的重要因素，因此需要进一步研究。
