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Increased Monthly Migraine Days Associated With Higher Productivity Loss, Acute Medication Use

David Bai, PharmD
Data from 3 erenumab clinical trials of patients with migraine have identified that an increase in the frequency of monthly migraine days leads to an increase in acute medication use and productivity loss.
Data from 3 erenumab clinical trials of patients with migraine have identified that an increase in the frequency of monthly migraine days (MMDs) leads to an increase in acute medication use and productivity loss.

A migraine is often considered a severe headache with varying degrees of throbbing pain. Untreated migraines usually last between 4 to 72 hours and contain identifiable pain features such as unilateral, throbbing, moderate to severe pain intensity, and exacerbation with physical activity, as well as symptoms including nausea or vomiting or photophobia and phonophobia.

The consequences of migraines are immense, with high healthcare costs and diminished quality of life and productivity. To determine the impact of migraines on acute medication use and patient productivity, researchers used data from 3 clinical trials assessing erenumab, the first calcitonin gene-related peptide inhibitor approved for the prevention of migraine.

Patients included for analysis had either episodic migraines or chronic migraine. On average, a patient experiencing 8 MMDs is predicted to use migraine-specific acute medications, such as triptans and ergotamine, on 2.92 days and nonmigraine-specific acute medications, such as Tylenol and nonsteroidal anti-inflammatory drugs, on 2.75 days per month. The costs associated sums to a mean of $21.22 for migraine-specific acute medications and $4.34 for nonmigraine-specific acute medications per month.

For patients with chronic migraine experiencing 18 MMDs, the use of migraine-specific acute medications and nonmigraine-specific acute medications were considerably higher, at 7.06 days and 4.81 days, respectively. Costs on average were also much higher, $60.40 for migraine-specific acute medications, and $11.75 for nonmigraine-specific acute medications.

Although costs associated with acute medication use were relatively low, it did not account for the indirect costs related to productivity loss. For patients with 8 MMDs, a mean of 0.95 absenteeism days and 2.34 presenteeism days resulted in an average cost of $197.52 and $242.86, respectively, per month. Patients with chronic migraine and 18 MMDs were predicted to have 1.86 absenteeism days and 5.18 presenteeism days per month. Costs disproportionately increased, with average costs per month of $387.25 for absenteeism days and $538.81 for presenteeism days per month.

Based on the data collected from the 3 erenumab clinical trials, investigators concluded that as MMDs increased, so did acute medication use and productivity loss. Although the correlation was nonlinear, clinicians should still focus on providing appropriate migraine preventive therapies to reduce productivity loss and costs.

Reference

Porter JK, Di Tanna GL, Lipton RB, Sapra S, Villa G. Costs of acute headache medication use and productivity losses among patients with migraine: insights from three randomized controlled trials [published online October 30, 2018]. Pharmacoecon Open. doi: 10.1007/s41669-018-0105-0.

 
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