Real-world Impact of Fremanezumab on Migraine-Related Health Care Resource Utilization in Patients with Comorbidities, Acute Medication Overuse, and/or Unsatisfactory Prior Migraine Preventive Response

Dawn C Buse; Lynda J Krasenbaum; Michael J Seminerio; Elizabeth R Packnett; Karen Carr; Mario Ortega; Maurice T Driessen

doi:10.1007/s40122-024-00583-9

Real-world Impact of Fremanezumab on Migraine-Related Health Care Resource Utilization in Patients with Comorbidities, Acute Medication Overuse, and/or Unsatisfactory Prior Migraine Preventive Response

Pain Ther. 2024 Mar 12. doi: 10.1007/s40122-024-00583-9. Online ahead of print.

Authors

Dawn C Buse¹, Lynda J Krasenbaum², Michael J Seminerio³, Elizabeth R Packnett⁴, Karen Carr³, Mario Ortega³, Maurice T Driessen⁵

Affiliations

¹ Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA.
² Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA.
³ Teva Branded Pharmaceuticals, Parsippany, NJ, USA.
⁴ , Merative, Ann Arbor, MI, USA.
⁵ Teva Pharmaceuticals, Piet Heinkade 107, 1019 BR, Amsterdam, Netherlands. Maurice.Driessen@Tevaeu.com.

PMID: 38472655
DOI: 10.1007/s40122-024-00583-9

Abstract

Introduction: Fremanezumab, a humanized monoclonal antibody targeting calcitonin gene-related peptide, is indicated for preventive treatment of migraine in adults. Real-world evidence assessing the effect of fremanezumab on migraine-related medication use, health care resource utilization (HCRU), and costs in patient populations with comorbidities, acute medication overuse (AMO), and/or unsatisfactory prior migraine preventive response (UPMPR) is needed.

Methods: Data for this US, retrospective claims analysis were obtained from the Merative^® MarketScan^® Commercial and supplemental databases. Eligible adults with migraine initiated fremanezumab between 1 September 2018 and 30 June 2019 (date of earliest fremanezumab claim is the index date), had ≥ 12 months of continuous enrollment prior to initiation (preindex period) and ≥ 6 months of data following initiation (postindex period; variable follow-up after 6 months), and had certain preindex migraine comorbidities (depression, anxiety, and cardiovascular disease), potential AMO, or UPMPR. Changes in migraine-related concomitant acute and preventive medication use, HCRU, and costs were assessed pre- versus postindex.

Results: In total, 3193 patients met the eligibility criteria. From pre- to postindex, mean (SD) per patient per month (PPPM) number of migraine-related acute medication and preventive medication claims (excluding fremanezumab), respectively, decreased from 0.97 (0.90) to 0.86 (0.87) (P < 0.001) and 0.94 (0.74) to 0.81 (0.75) (P < 0.001). Migraine-related outpatient and neurologist office visits, emergency department visits, and other outpatient services PPPM decreased pre- versus postindex (P < 0.001 for all), resulting in a reduction in mean (SD) total health care costs PPPM from US$541 (US$858) to US$490 (US$974) (P = 0.003). Patients showed high adherence and persistence rates, with mean (SD) proportion of days covered of 0.71 (0.29), medication possession ratio of 0.74 (0.31), and persistence duration of 160.3 (33.2) days 6 months postindex.

Conclusions: Patients with certain migraine comorbidities, potential AMO, and/or UPMPR in a real-world setting had reduced migraine-related medication use, HCRU, and costs following initiation of fremanezumab. Graphical abstract available for this article.

Keywords: Acute medication overuse; Adherence; CGRP; Costs; Fremanezumab; HCRU; Migraine; Real-world evidence.