Healthcare Resource Utilization after Initiation of a Triptan

San Diego—A new retrospective analysis of patients suffering from migraines found that the use of triptans did not decrease the utilization of healthcare resources, and, in some cases, was associated with an increase in utilization. These findings were recently presented during a poster session at the AMCP meeting. The poster was titled Healthcare Resource Utilization after Initiation of a Triptan.

According to the researchers, previous research has found that although triptans have been shown to be effective for patients suffering from migraines, adherence to these medications is often low, likely limiting the potential benefits of the medication.

In this study, researchers conducted a retrospective claims analysis using a large national database of medical and pharmacy claims data to determine whether the use of triptans had an impact on the utilization of healthcare resources for patients who had a diagnosis of acute migraine.

Researchers examined data for patients who had their first migraine diagnosis at least 12 months before their first pharmacy claim for a triptan, and then followed those patients for an equal amount of time after their first claim. They assessed utilization of healthcare resources in several areas including physician office visits, emergency department (ED) visits, hospitalizations, diagnostic imaging, and prescription pharmacy claims.

The primary focus of the study was the change in the use of healthcare resources before and after the initiation of triptans; researchers conducted a secondary analysis that compared healthcare resource utilization of patients taking opioids concomitantly with triptans to those who were not taking opioid medication.

Researchers found that of the 9521 patients in their sample population, 41% filled their prescription for a triptan once, whereas 40% refilled their prescriptions at least once and consistently used only 1 triptan. Other patients (16%) were found to have switched triptans once during the study period, while 3% switched triptans at least twice.

The group that filled a triptan prescription once was the only group to use fewer healthcare resources after the prescription was filled. This group saw significant decreases in both the rate of office visits (mean visits of 2.52 vs 2.30) and diagnostic imaging (mean of 0.06 vs 0.04) after the patient used a triptan; no significant changes were seen in the use of other healthcare resources.

By contrast, those patients who refilled their medication at least once and only used 1 triptan saw a significant increase in the rate of mean office visits (2.76 vs 2.24 before a triptan was used). There were no significant changes in the use of other healthcare resources.

Further, patients who switched triptans once during the study period had significant increases in office visit rates, ED visits, and hospitalizations, according to the analysis.

Significant increases in office visit rates and ED use were also seen in those patients who switched their triptan ≥2 times.

When researchers assessed opioid use, they found there was increased opioid, acetaminophen/nonsteroidal anti-inflammatory drug, and migraine prophylaxis use in patients who had filled their triptan prescription regardless of how often they switched triptans when compared with the pretriptan utilization data. They also noted that they found higher utilization rates of all medication and pharmacy services for those concomitant opioid users compared with those who were not taking opioids.

Researchers acknowledged that the study did have several limitations including that multiple factors could have led to patients switching triptans, researchers did not have data on over-the-counter use of medications to treat migraines, and most migraine patients would not have waited a year before filling their triptan prescription.

This study was supported by Allergan, Inc.