Patient characteristics and treatment utilization among patients with migraine initiating self-injectable calcitonin gene-related peptide monoclonal antibody and novel acute medication

Abstract

Objective

This study describes patient characteristics and utilization of recently approved novel acute medication and calcitonin gene-related peptide (CGRP) monoclonal antibodies.

Methods

This retrospective observational study utilized the IBM MarketScan Research Database and Optum’s Clinformatics Data Mart from May 2017 through December 2020 (index period). Adult patients initiating self-injectable CGRP monoclonal antibodies (mAbs) (erenumab, fremanezumab, galcanezumab) and novel acute migraine medications (lasmiditan, rimegepant, ubrogepant) with: (a) ≥3 months overlap between the index medication and second medication initiated along with it; (b) ≥1 claim for migraine diagnosis; and (c) continuous medical and pharmacy benefits 12 months pre- and 3 months post-index were included. Data are presented descriptively.

Results

A total of 2840 patients from the MarketScan database and 657 patients from the Optum database were included. Identified patients’ (MarketScan/Optum) mean age was 44.7/51.2 years; they were mostly women (88.8%/87.7%); a majority had a chronic migraine diagnosis (64.4%/71.4%) and were prescribed both preventive and acute treatments for migraine in the pre-index period. Most patients received a combination of both preventive and acute medications binding CGRP receptors (43.6%/59.0%) or preventive medication binding CGRP ligands and acute medication binding CGRP receptors (51.9%/34.9%). Mean (SD) number of days of concomitant use of CGRP and novel acute medications were: MarketScan, 29.1 (18.7); Optum, 31.8 (20.4). Prescribing patterns were similar across healthcare provider types within each database.

Conclusions

Understanding patient characteristics and treatment utilization patterns among patients prescribed both a CGRP mAb and novel acute medication may provide valuable insight regarding migraine treatment selection for healthcare decision makers.

Keywords:

• Calcitonin gene-related peptide
• healthcare provider
• migraine
• drug utilization

Transparency

Declaration of funding

This work was supported by Eli Lilly and Company, Indianapolis, USA.

Declaration of financial/other relationships

O.J.V., M.H., W.Y. and R.N. have disclosed that they are full-time employees and/or stockholders of Eli Lilly and Company. A reviewer on this manuscript has disclosed that they have received honoraria from Eli Lilly, Novartis and Teva. Other peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors made substantial contributions to conception and design, acquisition of data, or analyses and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Ethical approval

All study data were accessed with protocol compliant with the US patient confidentiality requirements, including the HIPAA 1996 regulations. As all databases used in the study are fully de-identified and compliant with the HIPAA, this study was exempt from Institutional Review Board approval.

Acknowledgements

The authors thank Janet H. Ford (Eli Lilly and Company, Indianapolis, IN, USA) for providing input during study design and implementation. Rahul Nikam, an employee of Eli Lilly Services India Pvt Ltd, provided writing support.

Data availability statement

The data that support the study findings were provided by IBM and Optum. Restrictions apply to the availability of these data, which were used under license for this study and therefore are not publicly available. Requests may be sent to IBM and Optum for more information on data availability and licensing.