Triptan Cycling Linked to Higher Migraine Treatment Costs and Resource Use

Patients who cycled through 2 or more triptans experienced significantly higher medication overuse headache diagnoses, greater healthcare resource utilization, and higher medical and prescription costs compared to those who continued using their initial triptan, according to a new study. Results were presented at the 2024 Annual Scientific Meeting of the American Headache Society. 

The retrospective claims analysis included data from MarketScan Commercial and Medicare Databases for the period covering January 1, 2015, through February 28, 2023 in patients >18 years old with a migraine diagnosis and at least 1 prescription for triptan treatment. In all, the analyses included 184,717 new triptan users, with 49.5% continuing the same triptan and 12.4% using 2 or more different triptans over 24 months. In terms of outcomes reported, those who used 2 or more triptans experienced higher resource utilization and costs: 

• The multiple triptan group had higher rates of acute (48.8% vs 29.6%) and preventive (83.1% vs 68.9%) migraine treatment use.
• Diagnosed medication overuse headache occurred in 3.5% of the multiple triptan cohort versus 1.1% of the single triptan group (odds ratio 2.98). 
• Migraine-related emergency department, imaging, and outpatient visits were 1.4, 1.3, and 1.4 times higher, respectively, in the multiple triptan group.
• Adjusted migraine-related medical costs were $2235 higher (mean ratio 1.88) and prescription costs were $1939 higher (mean ratio 2.31) for patients cycling through two or more triptans compared to those continuing their initial triptan.

The findings highlight the economic burden associated with poor response to triptans, underscoring the need to explore alternative treatment approaches for patients who do not respond adequately to their first triptan.