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Changes in Resource Use and Outcomes for Patients With Migraine Treated With Sumatriptan
A Managed Care Perspective
Jennifer H. Lofland, PharmD;
Nelda E. Johnson, PharmD;
Alice S. Batenhorst, PharmD;
David B. Nash, MD, MBA
Arch Intern Med. 1999;159:857-863.
Background Migraine headaches result in significant patient suffering and high costs to managed care organizations and employers. Studies that evaluate patient outcomes and the financial consequences of migraine treatment are important from a clinical and an economic perspective.
Methods This prospective, observational study assessed the outcomes of migraineurs in a mixed model staff/independent practice association managed care organization for patients previously diagnosed as having migraine who received their first prescription for sumatriptan. Data collected included medical as well as pharmacy claims and patient surveys to measure changes in satisfaction, health-related quality of life, workplace productivity, and nonworkplace activity after sumatriptan therapy was initiated.
Results A total of 178 patients completed the study. Results showed significant decreases in the mean number of migraine-related physician office visits, emergency department visits, and medical procedures in the 6 months after sumatriptan therapy compared with the 6 months before sumatriptan was used (P<.05). Four of the health-related quality-of-life dimensions and the physical component summary score measured by the SF-36 (which is a valid, reliable general health status instrument) showed significant improvements at 6 months compared with patients' scores before use of sumatriptan (P<.05). Health-related quality of life measured by the disease-specific instrument MSQ (Migraine-Specific Quality of Life Questionnaire-Version 1.0, 1992 Glaxo Wellcome Inc, Research Triangle Park, NC) showed significant improvement at 3 and at 6 months compared with baseline scores (P<.05). There were also improvements in patient satisfaction and significant reductions in time lost from workplace productivity and nonworkplace activity.
Conclusion In the 6 months after sumatriptan therapy was initiated, health care resource use and time lost from workplace productivity and nonworkplace activity were reduced, while health-related quality of life and patient satisfaction scores improved for the managed care migraineurs enrolled in this study.
From the Office of Health Policy and Clinical Outcomes, Thomas Jefferson University, Philadelphia, Pa (Drs Lofland and Nash); University of Illinois at Chicago, Chicago (Dr Johnson); and Glaxo Wellcome Inc, Research Triangle Park, NC (Dr Batenhorst).
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