Prescription Patterns and the Cost of Migraine Treatments in German General and Neurological Practices.
The aim of this study was to analyze prescription patterns and the cost of migraine treatments in general practices (GPs) and neurological practices (NPs) in Germany.



This study included 43,149 patients treated in GPs and 13,674 patients treated in NPs who were diagnosed with migraine in 2015. Ten different families of migraine therapy were included in the analysis: triptans, analgesics, anti-emetics, beta-blockers, antivertigo products, gastroprokinetics, anti-epileptics, calcium channel blockers, tricyclic antidepressants, and other medications (all other classes used in the treatment of migraine including homeopathic medications). The share of migraine therapies and their costs were estimated for GPs and NPs.



The mean age was 44.4 years in GPs and 44.1 years in NPs. Triptans and analgesics were the 2 most commonly prescribed families of drugs in all patients and in the 9 specific subgroups. Interestingly, triptans were more commonly prescribed in NPs than in GPs (30.9% to 55.0% vs. 30.0% to 44.7%), whereas analgesics were less frequently given in NPs than in GPs (11.5% to 17.2% vs. 35.3% to 42.4%). Finally, the share of patients who received no therapy was higher in NPs than in GPs (33.9% to 58.4% vs. 27.5% to 37.9%). The annual cost per patient was €66.04 in GPs and €94.71 in NPs. Finally, the annual cost per patient increased with age and was higher in women and in individuals with private health insurance coverage than in men and individuals with public health insurance coverage.



Triptans and analgesics were the 2 most commonly prescribed drugs for the treatment of migraine. Furthermore, approximately 30% to 40% of patients did not receive any therapy. Finally, the annual cost per patient was higher in NPs than in GPs.
Department of Biology, Ecole Normale Superieure of Lyon, Lyon, France.
Louis
L
Jacob
Real World Evidence Solutions, IMS Health, Frankfurt, Germany.
Karel
K
Kostev
D000319:Adrenergic beta-Antagonists / Q000191:economics / Q000627:therapeutic use; D000328:Adult; D000700:Analgesics / Q000191:economics / Q000627:therapeutic use*; D016527:Drug Costs / Q000639:trends*; D011307:Drug Prescriptions / Q000191:economics; D005260:Female; D058006:General Practice / Q000191:economics / Q000639:trends*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D009462:Neurology / Q000191:economics / Q000639:trends*; D014363:Tryptamines / Q000191:economics / Q000627:therapeutic use*; D055815:Young Adult
D000319:Adrenergic beta-Antagonists; D000700:Analgesics; D014363:Tryptamines
analgesic; migraine; primary care; triptan