Real-world adherence to erenumab, rescue medication utilization, and work absenteeism for patients with migraine: Results from an outcomes-based agreement.
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Migraine prevalence is estimated to be 15% (approximately 50 million people) in the United States, posing a significant burden on the health care system and a top cause of years lived with disability. Consequently, migraine leads to increased work-related disability, including presenteeism and absenteeism. Novel prophylactic treatments for migraine that target the calcitonin gene-related peptide pathway, including monoclonal antibodies to the calcitonin gene-related peptide ligand or the calcitonin gene-related peptide receptor (calcitonin gene-related peptide monoclonal antibodies) and gepants, offer new options for migraine prevention. The advent of new medications presents an opportunity for development of outcomes-based agreements, particularly because these agents are more costly than traditional, nonspecific treatment alternatives. Outcomes-based agreements are pricing agreements between pharmaceutical manufacturers and payers, centered around predefined performance metrics to better align incentives and create shared risk between them. OBJECTIVE: To report results of an outcomes-based agreement that was executed in a large integrated delivery and finance health system for patients with migraine who were prescribed erenumab, an anti-calcitonin gene-related peptide pathway monoclonal antibody. METHODS: This is a prospective real-world analysis of commercial or health insurance exchange data from a large regional health system, based on parameters of an outcomes-based agreement. Eligible patients were new to calcitonin gene-related peptide monoclonal antibodies. Outcomes of interest included an erenumab adherence metric and changes in work absenteeism and rescue medication use. Proportion adherent and rescue medication use were assessed for the entire eligible patient cohort, whereas work absenteeism was only evaluated for a subset of eligible patients for whom work outcomes data were available. RESULTS: = 0.589). Absenteeism could have been impacted by the onset of the COVID-19 pandemic. CONCLUSIONS: As measured, adherence to erenumab was high within the cohort. The inclusion of a work outcomes cohort provided valuable insights about the clinical benefits of erenumab for migraine prevention. Our findings provide additional insights on the real-world use of erenumab within the context of an outcomes-based agreement.
Source: PubMed
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4408089782