Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 09, 2019; 92 (15 Supplement) May 8, 2019

Undiagnosed Chronic Migraine Is Associated With Higher Economic Burden Compared With Diagnosed Chronic Migraine: Results From a Claims-Based Retrospective Study (P4.10-004)

Steven C. Marcus, Anand R. Shewale, William B. Young, Justin S. Yu, Jelena M. Pavlovic, Hema N. Viswanathan, Jalpa A. Doshi
First published April 16, 2019,
Steven C. Marcus
1University of Pennsylvania Philadelphia PA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anand R. Shewale
2Allergan plc Irvine CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William B. Young
3Thomas Jefferson University Philadelphia PA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Justin S. Yu
2Allergan plc Irvine CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jelena M. Pavlovic
4Albert Einstein College of Medicine Bronx NY United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hema N. Viswanathan
2Allergan plc Irvine CA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jalpa A. Doshi
1University of Pennsylvania Philadelphia PA United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Citation
Undiagnosed Chronic Migraine Is Associated With Higher Economic Burden Compared With Diagnosed Chronic Migraine: Results From a Claims-Based Retrospective Study (P4.10-004)
Steven C. Marcus, Anand R. Shewale, William B. Young, Justin S. Yu, Jelena M. Pavlovic, Hema N. Viswanathan, Jalpa A. Doshi
Neurology Apr 2019, 92 (15 Supplement) P4.10-004;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
0

Share

  • Article
  • Info & Disclosures
Loading

Abstract

Objective: To apply a claims-based algorithm to identify potentially undiagnosed chronic migraine (CM) patients and compare 12-month direct costs of potentially undiagnosed versus diagnosed CM patients.

Background: Approximately 7.7% of those with migraine have a CM diagnosis; however, it is estimated that 75% of those with CM are undiagnosed. Little is known about the economic burden of undiagnosed CM.

Design/Methods: Adults having ≥2 migraine diagnoses (346.xx) ≥30 days apart with migraine claims between 7/1/14 and 6/30/15 and continuously enrolled ≥12 months pre- and post-index date were identified from a large US claims database. Patients with ≥2 CM diagnoses (346.7x) ≥30 days apart were assigned to diagnosed CM cohort. A recently developed algorithm was applied to identify potentially undiagnosed CM patients from the group of migraine patients without diagnosed CM (ie, no claim for 346.7x or onabotulinumtoxinA during study period). Algorithm predicts CM status based on gender, number of acute medication claims, unique preventive classes, and healthcare visits; it has 78% sensitivity and 73% specificity. The 12-month post-index all-cause costs were compared between diagnosed CM and potentially undiagnosed CM cohorts. Generalized linear models controlling for patient age, gender, region, plan type, comorbidity score, and other migraine-related comorbidities were used to estimate adjusted costs.

Results: Study included 5555 diagnosed CM patients and 12,780 potentially undiagnosed CM patients. Mean adjusted total direct costs were significantly higher for undiagnosed CM group ($26,019) than for diagnosed CM group ($22,826, P<0.05). Mean adjusted medical costs for undiagnosed CM patients ($21,973) were higher than for diagnosed CM patients ($17,433, P<0.05). Mean adjusted pharmacy costs for undiagnosed CM patients ($3856) were lower versus diagnosed CM patients ($4928, P<0.05).

Conclusions: Undiagnosed CM was associated with significantly higher total healthcare costs and direct medical costs than diagnosed CM. Initiatives to better identify and manage such patients are needed.

Disclosure: Dr. Marcus has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan. Dr. Shewale has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities as a full-time employee of Allergan plc. Dr. Shewale holds stock and/or stock options in Allergan plc which sponsored research in which Dr. Shewale was involved as an investigator. Dr. Young has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Alder, Allergan, Cipla, Lilly, Supernus. Dr. Young has received research support from AGA, Alder, Allergan, Amgen, Autonomic Technology, Cumberland, Dr. Reddy Laboratories, Eli Lilly, Eneura Inc, Merz, and St. Jude Medical. Dr. Yu has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan, Inc. Dr. Yu holds stock and/or stock options in Allergan, Inc. Dr. Pavlovic has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Alder Pharmaceuticals, Allergan, Dr. Reddy’s Laboratories, and the American Headache Society. Dr. Viswanathan has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan, Inc. Dr. Viswanathan holds stock and/or stock options in Allergan, Inc., which sponsored research in which Dr. Viswanathan was involved as an investigator. Dr. Viswanathan holds stock and/or stock options in Allergan, Inc. Dr. Doshi has received personal compensation for consulting for Alkermes, Forest Laboratories (now Allergan), Ironwood Pharmaceuticals, Shire, and Vertex Pharmaceuticals. Dr. Doshi holds stock and/or stock options in Merck and Pfizer, which sponsored research in which Dr. Doshi was involved as an investigator. Dr. Doshi has received research support from has previously received research funding from AbbVie, Biogen, Humana, Janssen, PhRMA, Pfizer, Regeneron, Sanofi, and the National Pharmaceutical Council.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: 99 (1)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise