OBJECTIVES: Patients with common comorbidities, acute medication overuse (AMO), or difficult-to-treat migraine (DTTM) may have high healthcare resource utilization (HCRU) and costs. There are limited real-world data on use of fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) targeting calcitonin gene-related peptide (CGRP), in these patients. This retrospective claims database study evaluated migraine-related HCRU and costs for patients with comorbidities, AMO, or DTTM initiating fremanezumab treatment.

METHODS: Adult patients (≥18 years) initiating fremanezumab treatment between September 1, 2018–June 30, 2019 (date of earliest claim=index date) were identified from the IBM/MarketScan Commercial and Medicare supplemental database, which contains health care service and outpatient prescription data from a convenience sample of individuals with employer-sponsored health insurance in the US. Other inclusion criteria were 12 months of continuous enrollment in the database pre-index, ≥6 months of data post-index, and evidence of comorbidities, AMO, or DTTM pre-index, defined by presence of major depressive disorder, generalized anxiety disorder, cardiovascular disease; potential AMO in the 90 days pre-index; or inadequate response to ≥2 previous preventive medication classes.

RESULTS: 3,193 patients with comorbidities, AMO, or DTTM were included. For post-index versus pre-index, mean (SD) migraine-related HCRU per-patient-per-month (PPPM) was significantly lower for neurologist visits (0.14 [0.17] versus 0.15 [0.18]), outpatient office visits (0.32 [0.35] versus 0.35 [0.31]), and acute medication claims (0.86 [0.87] versus 0.97 [0.90]; all P<0.001). Consequently, post-index versus pre-index, significantly lower mean (SD) migraine-related costs PPPM were reported for office visits ($38 [45] vs $46 [46]), neurologist office visits ($17 [24] vs $21 [28]), acute medication ($74 [219] vs $93 [224]; all P<0.001), and migraine-related health care costs PPPM (excluding fremanezumab costs; $490 [974] versus $541 [858], P=0.003).

CONCLUSIONS: Statistically significant reductions in migraine-related HCRU and migraine-related health care costs were observed in patients with comorbidities, AMO, or DTTM following initiation of fremanezumab treatment.