Changes in resource use and outcomes for patients with migraine treated with sumatriptan - A managed care perspective

Background: Migraine headaches result in significant patient suffering and high costs to managed care organizations and employers. Studies that evalua te patient outcomes and the financial consequences of migraine treatment ar e important from a clinical and an economic perspective. Methods: This prospective, observational study assessed the outcomes of mig raineurs in a mixed model staff/independent practice association managed ca re organization for patients previously diagnosed as having migraine who re ceived their first prescription for sumatriptan. Data collected included me dical as well as pharmacy claims and patient surveys to measure changes in satisfaction, health-related quality of life, workplace productivity, and n onworkplace activity after sumatriptan therapy was initiated. Results: A total of 178 patients completed the study. Results showed signif icant decreases in the mean number of migraine-related physician office vis its, emergency department visits, and medical procedures in the 6 months af ter sumatriptan therapy compared with the 6 months before sumatriptan was u sed (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, r eliable general health status instrument) showed significant improvements a t 6 months compared with patients' scores before use of sumatriptan (P<.05) . Health-related quality of life measured by the disease-specific instrumen t MSQ (Migraine-Specific Quality of Life Questionnaire-Version 1.0, 1992 Gl are Wellcome Inc, Research Triangle Park, NC) showed significant improvemen t at 3 and at 6 months compared with baseline scores (P<.05). There were al so 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 nonworkpla ce activity were reduced, while health-related quality of life and patient satisfaction scores improved for the managed care migraineurs enrolled in t his study.