WellManaged – Migraines

Migraines are a painful and debilitating form of headache that affect 39 million individuals in the United States. Moreover, 4 million people are affected by chronic migraines, and experience at least 15 migraine days per month, as reported by the Migraine Research Foundation. Estimated healthcare and lost productivity costs associated with migraines are as high as $36 billion annually in the U.S.A. and American employers lose more than $13 billion each year as a result of 113 million lost work days due to this therapeutic condition.

WellDyneRx proactively targets this disease state through the WellManaged-Migraine program. Like all of the programs included in the WellManaged – Clinical Suite, the WellManaged-Migraine program provides member education, identifies gaps in therapy, and targets high-risk members to improve clinical outcomes. The WellManaged-Migraine program also incorporates patient-reported outcomes (PROs) to foster comprehensive and collaborative care.

Calcitonin gene-related peptide (CGRP) antagonists are a new drug class indicated for chronic migraine prevention. This novel drug class brought about the launch of three drug therapies in 2018: Aimovig, Emgality, and Ajovy. These drugs differ in administration, but are similar in both clinical efficacy and cost. Traditionally, Botox was the only long-acting injectable therapy for chronic migraines, but there is little real- world evidence that compares PROs of CGRP antagonists to Botox. USSC pharmacists engage patients who recently started these medications and assess a number of key treatment-related outcomes that include response to therapy, migraine days per month, quality of life, and more.

Our program found that there was no clinical differences in headache reduction or quality of life between patients on Botox and patients on CGRP therapy. In addition, both therapies showed significant reductions in reported pain severity and overall migraine days per month. Continued monitoring of these patients may unveil more defined differences in these recently approved therapies. This approach allows WellDyneRx to incorporate real-world evidence in future Pharmacy and Therapeutics Committee and Pharamcoeconomic Committee meetings to ensure that the most clinically and cost-effective therapies are included in our formularies.

2019 Quarter One WellInformed Table Contents