Abstract Details

Title Triptan Discontinuation and Treatment Patterns Among Migraine Patients Initiating Triptan Treatment in a US Commercially Insured Population

Topic Headache

Presentation(s) S59 - Migraine: Impact, Treatment Patterns and Resource Utilization (1:22 PM-1:33 PM)

Poster/Presentation
Number 003

Background Migraine is a chronic disease with episodic attacks defined by often incapacitating neurological symptoms. Triptans are commonly prescribed for the acute treatment of migraine attacks.

Objective To examine real-world patterns of acute treatment of migraine among new triptan users in a commercially insured US population.

Design/Methods Adult patients were selected if they had ≥1 triptan claim between January 1, 2013 and December 31, 2013 (first claim assigned as index date) and at least 12 months of pre- and 24 months of post-index continuous enrollment in the Optum Clinformatics™ claims database. Patients were required to have ≥1 migraine diagnosis but no prior triptan claims in the pre-index period. Treatment patterns among these patients initiating a new triptan were examined over a 12- and 24-month period.

Results In our sample of 10,509 new triptan users, 50.8% did not refill their index triptan over the 12-month post-index period and 43.6% did not refill it over the 24-month period. The majority of the new triptan users (56.4%) had a quantity of ≤4 pills on their first fill; refill rates were similarly low in these patients. Only 8.4% of the new triptan users received 2 different triptan agents and 1% received 3 different triptan agents over 24 months. Approximately 35% of patients filled ≥1, whereas another 10% filled ≥2, guideline-listed agents from a non-triptan acute medication class over 24 months, most commonly for an NSAID followed by butalbital combination. However, over half of all new triptan users (54.3%) and the subgroup with no refills for their initial triptan (52.6%) had filled a guideline- or non–guideline-listed opioid medication over the 24-month follow-up.

Conclusions These results demonstrate poor refill patterns and minimal use of >2 different triptan agents over a 2-year period in a large, commercially insured population of new triptan users in the US.

Authors/Disclosures
PRESENTER	No disclosure on file
Anand R. Shewale (AbbVie)	Anand R. Shewale has received personal compensation for serving as an employee of AbbVie. Anand R. Shewale has stock in AbbVie.
Stephen D. Silberstein, MD, FAAN (Jefferson Headache Center)	Dr. Silberstein has received publishing royalties from a publication relating to health care.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
William B. Young, MD, FAAN (Jefferson Headache Center)	Dr. Young has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven Pharmaceuticals. Dr. Young has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly and Company. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Young has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven Pharmaceuticals Inc. Dr. Young has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly and Company. Dr. Young has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Young has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Coalition for Headache and Migraine Patients. Dr. Young has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Miles for Migraine. The institution of Dr. Young has received research support from Amgen. The institution of Dr. Young has received research support from Cumberland. The institution of Dr. Young has received research support from Eli Lilly. The institution of Dr. Young has received research support from Novartis. The institution of Dr. Young has received research support from PCORI. The institution of Dr. Young has received research support from Satsuma. The institution of Dr. Young has received research support from Scion. The institution of Dr. Young has received research support from Teva. The institution of Dr. Young has received research support from Zosano.
Hema Viswanathan	Ms. Viswanathan has received personal compensation for serving as an employee of Allergan plc. Ms. Viswanathan has received personal compensation for serving as an employee of Precision Medicine Group. Ms. Viswanathan has received stock or an ownership interest from Allergan plc. Ms. Viswanathan has received stock or an ownership interest from Precision Medicine Group.
	No disclosure on file

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