Urman Robert, Princic Nicole, Vuvu Fiston, Patel Leah B, Oh Sam, Chandler David, Hindiyeh Nada, Bensink Mark E
Amgen Inc., One Amgen Centre Drive, Thousand Oaks, CA, 91320, USA.
Merative, Ann Arbor, MI, USA.
Pain Ther. 2024 Oct;13(5):1299-1313. doi: 10.1007/s40122-024-00644-z. Epub 2024 Aug 23.
Erenumab-aooe is approved for the preventive treatment of migraine in adults. Recent publications have evaluated migraine medication use during the 6 months after starting erenumab, but longer-term follow-up data are limited. The objective of this study was to describe 12-month medication use and changes in healthcare resource utilization (HRU) and associated direct costs among patients initiating erenumab.
We identified adult patients with an erenumab claim in the Merative MarketScan Commercial and Medicare Databases from May 2018 through September 2019. Eligible patients had ≥ 12 months of continuous medical and pharmacy coverage before (pre-index period) and after (post-index period) the index date (first erenumab claim) in addition to pre-index evidence of migraine. Patients were stratified by post-index-period adherence to erenumab, defined as ≥ 80% of days covered (adherent) or < 80% of days covered (non-adherent). Outcomes were measured pre- and post-index, and differences between these periods were described.
Among 7528 eligible patients, the mean (standard deviation) age was 45.1 (11.4) years and 85.4% were female; 38.5% of patients were adherent to erenumab. Most patients used acute or traditional migraine-preventive medications pre-index, with reductions in use observed post-index (acute medication was used by 95.6% of patients pre-index, compared to 92.3% post-index; traditional preventive medication was used by 89.6% of patients pre-index, compared to 81.9% post-index). Reductions were observed for HRU of emergency room visits (- 3.8%) and brain- and other head-imaging studies (- 7.5%). Overall costs associated with acute and traditional preventive medications were reduced (- $764), but costs for HRU increased slightly ($76). When stratifying by adherence and combining costs for acute and traditional preventive medications and HRU, adherent patients had cost decreases (- $1947), while non-adherent patients had cost increases ($101).
Most patients initiating erenumab had prior use of acute and traditional migraine-preventive therapies. The reduction in acute and traditional migraine-preventive medication use and HRU over the 12-month follow-up supports the long-term clinical benefits of erenumab in the real-world setting.
erenumab-aooe已被批准用于成人偏头痛的预防性治疗。最近的出版物评估了开始使用erenumab后6个月内偏头痛药物的使用情况，但长期随访数据有限。本研究的目的是描述开始使用erenumab的患者12个月的药物使用情况、医疗资源利用（HRU）的变化以及相关直接成本。
我们在2018年5月至2019年9月的Merative MarketScan商业和医疗保险数据库中识别出有erenumab报销记录的成年患者。符合条件的患者在索引日期（首次erenumab报销）之前（索引前期）和之后（索引后期）有≥12个月的连续医疗和药房保险，此外还有索引前期偏头痛的证据。患者根据索引后期对erenumab的依从性进行分层，依从性定义为覆盖天数≥80%（依从）或<80%（不依从）。在索引前后测量结果，并描述这些时期之间的差异。
在7528名符合条件的患者中，平均（标准差）年龄为45.1（11.4）岁，85.4%为女性；38.5%的患者依从erenumab治疗。大多数患者在索引前期使用急性或传统偏头痛预防性药物，在索引后期观察到使用量减少（索引前期95.6%的患者使用急性药物，索引后期为92.3%；索引前期89.6%的患者使用传统预防性药物，索引后期为81.9%）。急诊室就诊的HRU（-3.8%）和脑部及其他头部影像学检查（-7.5%）有所减少。与急性和传统预防性药物相关的总体成本有所降低（-764美元），但HRU成本略有增加（76美元）。按依从性分层并合并急性和传统预防性药物及HRU的成本时，依从性患者的成本降低（-1947美元），而不依从患者的成本增加（101美元）。
大多数开始使用erenumab的患者之前使用过急性和传统偏头痛预防性疗法。在12个月的随访中，急性和传统偏头痛预防性药物使用量及HRU的减少支持了erenumab在现实环境中的长期临床益处。
