Varnado Oralee J, Vu Michelle, Buysman Erin K, Kim Gilwan, Allenback Gayle, Hoyt Margaret, Trenz Helen, Cao Feng, Viktrup Lars
Eli Lilly and Company, Indianapolis, IN, USA.
Optum Life Sciences, HEOR, Eden Prairie, MN, USA.
Patient Prefer Adherence. 2025 Mar 1;19:543-567. doi: 10.2147/PPA.S492300. eCollection 2025.
To describe 24-month treatment patterns, healthcare resource utilization (HCRU), and direct costs of patients initiating galcanezumab (GMB) versus standard of care migraine preventive medications (SOC), stratified by gender and migraine type.
This retrospective cohort study used Optum's de-identified Market Clarity database (September 2018-March 2020) and included adults with migraine with ≥1 claim for GMB or SOC. Patients in the GMB cohort were stratified by gender (female/male) and migraine type (CM/EM), and propensity score matched 1:1 to patients in the SOC cohort. Treatment patterns, all-cause and migraine-related HCRU, and direct costs for GMB versus SOC cohorts were compared using a Z-test and reported over 24 months.
Following stratification and matching, the GMB and SOC cohorts included the following patient pairs: 2015-female, 292-male, 1024-CM, and 1282-EM. Treatment adherence, measured by proportion of days covered, and median time to treatment discontinuation were significantly greater in those initiating GMB compared with SOC in females, males, patients with CM, and patients with EM (all <0.001). Over 24 months, reduction in migraine-related ambulatory visits, office visits, and medical costs were significantly higher in GMB versus SOC cohorts in females and patients with CM. Increases in HCRU associated with preventive migraine medication counts and migraine-related total and pharmacy costs were significantly higher in GMB versus SOC cohorts in all subgroups.
While direct costs over 24 months were higher in patients initiating GMB for migraine prevention, better adherence and longer treatment duration with GMB regardless of gender or migraine type support the use of GMB compared with SOC.
描述开始使用加卡尼单抗（GMB）与偏头痛预防性治疗标准药物（SOC）的患者的24个月治疗模式、医疗资源利用（HCRU）及直接成本，并按性别和偏头痛类型进行分层。
这项回顾性队列研究使用了Optum的去识别化市场清晰度数据库（2018年9月至2020年3月），纳入了有≥1次GMB或SOC索赔记录的偏头痛成年患者。GMB队列中的患者按性别（女性/男性）和偏头痛类型（慢性偏头痛/发作性偏头痛）分层，并与SOC队列中的患者进行1:1倾向得分匹配。使用Z检验比较GMB与SOC队列的治疗模式、全因和偏头痛相关的HCRU及直接成本，并报告24个月的数据。
分层和匹配后，GMB和SOC队列包括以下患者对：2015名女性、292名男性、1024名慢性偏头痛患者和1282名发作性偏头痛患者。在女性、男性、慢性偏头痛患者和发作性偏头痛患者中，以覆盖天数比例衡量的治疗依从性以及治疗停药的中位时间，开始使用GMB的患者显著高于使用SOC的患者（均P<0.001）。在24个月内，女性和慢性偏头痛患者中，GMB队列与SOC队列相比，偏头痛相关的门诊就诊、办公室就诊和医疗成本的降低显著更高。在所有亚组中，GMB队列与SOC队列相比，与预防性偏头痛药物计数以及偏头痛相关的总费用和药房费用相关的HCRU增加显著更高。
虽然开始使用GMB预防偏头痛的患者24个月的直接成本较高，但无论性别或偏头痛类型，GMB具有更好的依从性和更长的治疗持续时间，这支持其与SOC相比的使用。
