PDF(Pubmed)
Abstract：
UNASSIGNED: Health care resource utilization (HCRU) and direct costs incurred over 12 months following initiation of galcanezumab (GMB) or standard-of-care (SOC) preventive migraine treatments have been evaluated. However, a gap in knowledge exists in understanding longer-term HCRU and direct costs.
UNASSIGNED: To compare all-cause and migraine-related HCRU and direct costs in patients with migraine initiating GMB or SOC preventive migraine treatments over a 24-month follow-up.
UNASSIGNED: This retrospective study used Optum deidentified Market Clarity Data. The study included adults diagnosed with migraine, with at least 1 claim for GMB or SOC preventive migraine therapy (September 2018 to March 2020), with continuous enrollment for 12 months before and 24 months after (follow-up) the index date (date of first GMB or SOC claim). Propensity score (PS) matching (1:1) was used to balance cohorts. All-cause and migraine-related HCRU and direct costs for GMB vs SOC cohorts were reported as mean (SD) per patient per year (PPPY) over a 24-month follow-up and compared using a Z-test. Costs were inflated to 2022 US$.
UNASSIGNED: After PS matching, 2,307 patient pairs (mean age: 44.4 years; female sex: 87.3%) were identified. Compared with the SOC cohort, the GMB cohort had lower mean (SD) PPPY all-cause office visits (17.9 [17.7] vs 19.1 [18.7]; P = 0.023) and migraine-related office visits (2.6 [3.3] vs 3.0 [4.7]; P = 0.002) at follow-up. No significant differences were observed between cohorts in other all-cause and migraine-related events assessed including outpatient visits, emergency department (ED) visits, inpatient stays, and other medical visits. The mean (SD) costs PPPY were lower in the GMB cohort compared with the SOC cohort for all-cause office visits ($4,321 [7,518] vs $5,033 [7,211]; P < 0.001) at follow-up. However, the GMB cohort had higher mean (SD) PPPY all-cause total costs ($24,704 [30,705] vs $21,902 [28,213]; P = 0.001) and pharmacy costs ($9,507 [12,659] vs $5,623 [12,605]; P < 0.001) compared with the SOC cohort. Mean (SD) costs PPPY were lower in the GMB cohort for migraine-related office visits ($806 [1,690] vs $1,353 [2,805]; P < 0.001) compared with the SOC cohort. However, the GMB cohort had higher mean (SD) PPPY migraine-related total costs ($8,248 [11,486] vs $5,047 [9,749]; P < 0.001) and migraine-related pharmacy costs ($5,394 [3,986] vs $1,761 [4,133]; P < 0.001) compared with the SOC cohort. There were no significant differences between cohorts in all-cause and migraine-related costs for outpatient visits, ED visits, inpatient stays, and other medical visits.
UNASSIGNED: Although total costs were greater for GMB vs SOC following initiation, changes in a few categories of all-cause and migraine-related HCRU and direct costs were lower for GMB over a 24-month follow-up. Additional analysis evaluating indirect health care costs may offer insights into further cost savings incurred with preventive migraine treatment.
UNASSIGNED: To compare all-cause and migraine-related HCRU and direct costs in patients with migraine initiating GMB or SOC preventive migraine treatments over a 24-month follow-up.
UNASSIGNED: This retrospective study used Optum deidentified Market Clarity Data. The study included adults diagnosed with migraine, with at least 1 claim for GMB or SOC preventive migraine therapy (September 2018 to March 2020), with continuous enrollment for 12 months before and 24 months after (follow-up) the index date (date of first GMB or SOC claim). Propensity score (PS) matching (1:1) was used to balance cohorts. All-cause and migraine-related HCRU and direct costs for GMB vs SOC cohorts were reported as mean (SD) per patient per year (PPPY) over a 24-month follow-up and compared using a Z-test. Costs were inflated to 2022 US$.
UNASSIGNED: After PS matching, 2,307 patient pairs (mean age: 44.4 years; female sex: 87.3%) were identified. Compared with the SOC cohort, the GMB cohort had lower mean (SD) PPPY all-cause office visits (17.9 [17.7] vs 19.1 [18.7]; P = 0.023) and migraine-related office visits (2.6 [3.3] vs 3.0 [4.7]; P = 0.002) at follow-up. No significant differences were observed between cohorts in other all-cause and migraine-related events assessed including outpatient visits, emergency department (ED) visits, inpatient stays, and other medical visits. The mean (SD) costs PPPY were lower in the GMB cohort compared with the SOC cohort for all-cause office visits ($4,321 [7,518] vs $5,033 [7,211]; P < 0.001) at follow-up. However, the GMB cohort had higher mean (SD) PPPY all-cause total costs ($24,704 [30,705] vs $21,902 [28,213]; P = 0.001) and pharmacy costs ($9,507 [12,659] vs $5,623 [12,605]; P < 0.001) compared with the SOC cohort. Mean (SD) costs PPPY were lower in the GMB cohort for migraine-related office visits ($806 [1,690] vs $1,353 [2,805]; P < 0.001) compared with the SOC cohort. However, the GMB cohort had higher mean (SD) PPPY migraine-related total costs ($8,248 [11,486] vs $5,047 [9,749]; P < 0.001) and migraine-related pharmacy costs ($5,394 [3,986] vs $1,761 [4,133]; P < 0.001) compared with the SOC cohort. There were no significant differences between cohorts in all-cause and migraine-related costs for outpatient visits, ED visits, inpatient stays, and other medical visits.
UNASSIGNED: Although total costs were greater for GMB vs SOC following initiation, changes in a few categories of all-cause and migraine-related HCRU and direct costs were lower for GMB over a 24-month follow-up. Additional analysis evaluating indirect health care costs may offer insights into further cost savings incurred with preventive migraine treatment.
摘要：
■已经评估了开始galcanezumab（GMB）或标准护理（SOC）预防性偏头痛治疗后12个月内发生的医疗保健资源利用率（HCRU）和直接费用。然而,在理解长期HCCU和直接成本方面存在知识差距。
■在24个月的随访中，比较开始GMB或SOC预防性偏头痛治疗的偏头痛患者的全因和与偏头痛相关的HCRU和直接成本。
■这项回顾性研究使用了Optum去识别市场清晰度数据。这项研究包括被诊断患有偏头痛的成年人，至少有1项GMB或SOC预防性偏头痛治疗索赔（2018年9月至2020年3月），在索引日期（首次GMB或SOC索赔的日期）之前（随访）之前和之后24个月连续纳入12个月。使用倾向评分(PS)匹配(1:1)来平衡队列。在24个月的随访中，将GMB与SOC队列的全因和偏头痛相关HCRU以及直接成本报告为每位患者每年（PPPY）的平均值（SD），并使用Z检验进行比较。成本膨胀至2022美元。
■PS匹配后，确定了2,307对患者（平均年龄：44.4岁；女性：87.3％）。与SOC队列相比，随访时,GMB队列的PPPY全因就诊次数(17.9[17.7]vs19.1[18.7];P=0.023)和偏头痛相关就诊次数(2.6[3.3]vs3.0[4.7];P=0.002)平均(SD)较低.在其他全因和偏头痛相关事件（包括门诊就诊）评估方面，队列之间没有观察到显著差异。急诊科（ED）访问，住院,和其他医疗访问。在随访时，GMB队列中PPPY的平均成本(SD)低于SOC队列的全因就诊($4,321[7,518]vs$5,033[7,211];P<0.001)。然而,GMB队列与SOC队列相比,PPPY全因总费用平均(SD)较高(24,704美元[30,705]vs21,902美元[28,213];P=0.001)和药费(9,507美元[12,659]vs5,623美元[12,605];P<0.001).与SOC队列相比，GMB队列中与偏头痛相关的办公室就诊的PPPY的平均(SD)成本较低(806[1,690]对1,353[2,805];P<0.001)。然而,GMB队列的平均(SD)PPPY偏头痛相关总费用($8,248[11,486]vs$5,047[9,749];P<0.001)和偏头痛相关药费($5,394[3,986]vs$1,761[4,133];P<0.001)高于SOC队列.在全因门诊就诊和偏头痛相关费用方面，队列之间没有显着差异，ED访问，住院,和其他医疗访问。
■尽管启动后GMB与SOC的总成本更高，在24个月的随访中,GMB的几类全因和偏头痛相关HCRU的变化和直接费用较低.评估间接医疗保健成本的其他分析可能会为预防性偏头痛治疗带来的进一步成本节省提供见解。
■在24个月的随访中，比较开始GMB或SOC预防性偏头痛治疗的偏头痛患者的全因和与偏头痛相关的HCRU和直接成本。
■这项回顾性研究使用了Optum去识别市场清晰度数据。这项研究包括被诊断患有偏头痛的成年人，至少有1项GMB或SOC预防性偏头痛治疗索赔（2018年9月至2020年3月），在索引日期（首次GMB或SOC索赔的日期）之前（随访）之前和之后24个月连续纳入12个月。使用倾向评分(PS)匹配(1:1)来平衡队列。在24个月的随访中，将GMB与SOC队列的全因和偏头痛相关HCRU以及直接成本报告为每位患者每年（PPPY）的平均值（SD），并使用Z检验进行比较。成本膨胀至2022美元。
■PS匹配后，确定了2,307对患者（平均年龄：44.4岁；女性：87.3％）。与SOC队列相比，随访时,GMB队列的PPPY全因就诊次数(17.9[17.7]vs19.1[18.7];P=0.023)和偏头痛相关就诊次数(2.6[3.3]vs3.0[4.7];P=0.002)平均(SD)较低.在其他全因和偏头痛相关事件（包括门诊就诊）评估方面，队列之间没有观察到显著差异。急诊科（ED）访问，住院,和其他医疗访问。在随访时，GMB队列中PPPY的平均成本(SD)低于SOC队列的全因就诊($4,321[7,518]vs$5,033[7,211];P<0.001)。然而,GMB队列与SOC队列相比,PPPY全因总费用平均(SD)较高(24,704美元[30,705]vs21,902美元[28,213];P=0.001)和药费(9,507美元[12,659]vs5,623美元[12,605];P<0.001).与SOC队列相比，GMB队列中与偏头痛相关的办公室就诊的PPPY的平均(SD)成本较低(806[1,690]对1,353[2,805];P<0.001)。然而,GMB队列的平均(SD)PPPY偏头痛相关总费用($8,248[11,486]vs$5,047[9,749];P<0.001)和偏头痛相关药费($5,394[3,986]vs$1,761[4,133];P<0.001)高于SOC队列.在全因门诊就诊和偏头痛相关费用方面，队列之间没有显着差异，ED访问，住院,和其他医疗访问。
■尽管启动后GMB与SOC的总成本更高，在24个月的随访中,GMB的几类全因和偏头痛相关HCRU的变化和直接费用较低.评估间接医疗保健成本的其他分析可能会为预防性偏头痛治疗带来的进一步成本节省提供见解。
