Pharmaceutically treated comorbidities and associated healthcare costs among triptan users in Switzerland: A pharmacoepidemiological study from a nationwide health insurance database

Pharmacoepidemiol Drug Saf. 2020 Mar;29(3):279-287. doi: 10.1002/pds.4938. Epub 2019 Dec 11.

Abstract

Purpose: In course of the new migraine drug development on the global market it is important to quantify the current burden of migraine medication. This study aimed to estimate the comorbidity burden and its relation to healthcare costs in patients using triptans in Switzerland by analyzing a large population-based database.

Methods: This retrospective cohort study was based on Swiss health insurance claims data (2015/2016). The study sample comprised adult patients with ≥1 triptan prescription in 2015. We evaluated pharmaceutically treated comorbid conditions (CCs) and costs (12 months after index prescription) of patients using triptan. Multivariable linear regression models with log-transformed outcomes were performed to identify the factors related to healthcare costs.

Results: From a total of 749 092, we identified 10,090 patients using triptans (1-year prevalence of 1.35%), whereas 58.9% had ≥2 CCs. The most frequent CCs were pain- and rheumatologic-related diseases and psychological disorders. Among triptan users, the mean total healthcare costs were highest in older patients with ≥2 CCs (>64 years: migraine with ≥2 CC "12 331 SFr"). Multivariate regression analyses showed that psychological disorders had the strongest impact on healthcare costs (Coefficient: 1.29; 95%-CI: 1.27-1.31).

Conclusions: The present study provides an overview of comorbidities and its related costs in migraine patients, which helps to quantify the current burden of migraine. This is relevant as the recently licensed CGRP antagonists are likely to change current treatment schemes for migraine, which strongly depends also on the comorbidities. The present study might therefore be helpful for the future development of treatment guidelines.

Keywords: comorbidity; costs; drug therapy; drug utilization; pharmacoepidemiology; triptan.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Databases, Factual
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Insurance Claim Review / trends
  • Insurance, Health
  • Male
  • Middle Aged
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / epidemiology
  • Pharmacoepidemiology
  • Retrospective Studies
  • Switzerland / epidemiology
  • Tryptamines / economics
  • Tryptamines / therapeutic use*

Substances

  • Tryptamines