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Healthy Skepticism Library item: 10883

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Feliu AL, Rupnow MF, Blount A, Boccuzzi SJ, Vermilyea J.
Resource use associated with topiramate in migraine prophylaxis.
Am J Health Syst Pharm 2007 Jul 15; 64:(14):1483-91
http://www.ajhp.org/cgi/content/full/64/14/1483


Abstract:

PURPOSE: The effect of topiramate prophylaxis on medication use and medical resource use for migraine patients was studied. METHODS: Medical and pharmacy claims from a commercially insured population were analyzed from July 1, 1999, to March 31, 2004. The study sample included patients with at least one physician encounter or facility claim with a diagnosis of migraine at any point during the study’s time frame. Patients either were naive to drugs labeled for migraine prophylaxis or had switched to topiramate from another drug labeled for migraine prophylaxis. The date of topiramate initiation was between January 1, 2000, and September 30, 2003; topiramate initiation was the index date. Demographic and clinical characteristics were evaluated. Migraine-related medication use and resource use were compared between the pre- and postindex periods. RESULTS: Of the 1749 patients analyzed, 90.2% were female. Neurologists wrote 54% of the index prescriptions. The mean +/- S.D. topiramate dosage was 98 +/- 65 mg/day. Statistically significant decreases occurred in the proportion of patients using drugs not labeled for migraine prophylaxis, nonopioid analgesics, nonsteroidal antiinflammatory drugs, and headache and migraine relief medications (p < 0.05). There was a 44.9% reduction in emergency room services, 53.2% reduction in migraine- related diagnostic procedures, and 57.1% reduction in migraine-related hospitalization days. Encounter claims for physicians’ office visits did not change significantly. CONCLUSION: Migraine patients within commercially insured health plans incurred substantial resource use. Within six months following initiation of topiramate preventive therapy, reductions in acute migraine medication and medical resource use were observed among this population of migraine sufferers.

 

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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963