Comparison of healthcare resource utilization and costs among patients with migraine with potentially adequate and insufficient triptan response

Steven C. Marcus, Anand R. Shewale, Stephen D. Silberstein, Richard B. Lipton, William B. Young, Hema N. Viswanathan, Jalpa A. Doshi

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Triptans are the most commonly prescribed acute treatments for migraine; however, not all triptan users experience adequate response. Information on real-world resource use and costs associated with triptan insufficient response are limited. Methods: A retrospective claims analysis using US commercial health plan data between 2012 and 2015 assessed healthcare resource use and costs in adults with a migraine diagnosis newly initiating triptans. Patients who either did not refill triptans but used other non-triptan medications or refilled triptans but also filled non-triptan medications over a 24-month follow-up period were designated as potential triptan insufficient responders. Patients who continued filling only triptans (i.e. triptan-only continuers) were designated as potential adequate responders. All-cause and migraine-related resource use and total (medical and pharmacy) costs over months 1–12 and months 13–24 were compared between triptan-only continuers and potential triptan insufficient responders. Results: Among 10,509 new triptan users, 4371 (41%) were triptan-only continuers, 3102 (30%) were potential triptan insufficient responders, and 3036 (29%) did not refill their index triptan or fill non-triptan medications over 24 months’ follow-up. Opioids were the most commonly used non-triptan treatment (68%) among potential triptan insufficient responders over 24 months of follow-up. Adjusted mean all-cause and migraine-related total costs were $5449 and $2905 higher, respectively, among potential triptan insufficient responders versus triptan-only continuers over the first 12 months. Conclusions: In a US commercial health plan, almost one-third of new triptan users were potential triptan insufficient responders and the majority filled opioid prescriptions. Potential triptan insufficient responder patients had significantly higher all-cause and migraine-related healthcare utilization and costs than triptan-only continuers.

Original languageEnglish (US)
Pages (from-to)639-649
Number of pages11
Issue number7
StatePublished - Jun 1 2020


  • Migraine
  • burden of illness
  • claims data
  • direct costs
  • migraine medication
  • payer costs
  • refill patterns
  • resource utilization

ASJC Scopus subject areas

  • Clinical Neurology


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