Migraine Treatment and Calcitonin Gene-Related Peptide Inhibitors: A Real-World Electronic Health Record Case Study
EXECUTIVE SUMMARY
Migraine, a primary headache disorder with significant physical, social, and occupational disability, is estimated to affect 36 million Americans. For patients aged 25 to 49 years, migraine is the third-leading global cause of years lived with disability. In the nearly 1 in 4 US households affected by migraine, family members reported migraine adversely affected family life as well as social or leisure activities. One in three employed respondents to a pharmaceutical survey indicated they turned down work opportunities, including promotions, owing to migraine. Costs of care and lost productivity associated with migraine are measured in tens of billions of dollars. Despite lifestyle modifications and the availability of acute and preventive pharmacotherapies that may mitigate pain and other symptoms and reduce the frequency of attacks, migraine remains inadequately treated in a significant number of patients.
This paper summarizes current knowledge regarding migraine and describes calcitonin generelated peptide (CGRP) inhibitors, a new therapeutic category of migraine-specific preventive treatment. The paper next considers how streamlining the path to safe and effective management of migraine might be facilitated through analysis of electronic health records (EHRs). Real-world evidence (RWE) derived from longitudinal, de-identified patient information contained on EHR platforms can provide insight regarding provider behavior, patient behavior, and reimbursement; additionally, it can inform medical innovation and product development and help estimate a medical product’s economic impact. With a focus on a new CGRP inhibitor, a case study using real-world data from the Practice Fusion EHR ambulatory platform suggests how RWE from patients with migraine may provide insights into the impact of episodic and chronic forms of migraine, management of migraine-related disease burden, and prevention of migraine disease progression.