OBJECTIVES: Rising prevalence of migraine causes a substantial impact on individuals and societal burden. This study aimed to investigate treatment patterns for migraine, including acute and preventive treatments in Taiwan using real-world database.

METHODS: The Taiwan National Health Insurance Database is a retrospective, longitudinal study on medical treatment in patients with migraine, conducted between 2013 and 2017. Migraine was defined in patients diagnosed with the codes ICD-9-CM 346.X or ICD-10-CM G43.X by physicians. They were followed until Dec 31, 2017. Treatment patterns of preventive medications (including beta-blockers, calcium channel blockers, anti-epileptics, anti-depressants and others) and acute medications (including ergotamine, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), triptans and narcotics) were reported. Descriptive statistics were performed by using SAS version 9.4 for Windows.

RESULTS: During the study period, 312,718 patients with migraine were identified with an average annual increase in prevalence of 1.3%. Of them, 255,577 patients (81.7%) received medications, divided into acute treatment (75.2%), preventive treatment (4.6%) and both (20.2%). Among patients treated with preventive medications, the majority (64.6%) had ever taken one drug, while 1.8% had tried more than 4 types of drugs. Calcium channel blockers (65.1%) was the most commonly prescribed medication followed by beta-blockers (37.7%) and anti-epileptic drugs (15.9%). Regarding patients with acute medications, 50.1% and 2.1% had ever taken one and more than 4 types of drugs respectively. Acetaminophen (35.7%), ergotamine (21.4%) and NSAID (15.5%) were the most commonly prescribed medications. Triptan use was low overall.

CONCLUSIONS: The analysis showed that one quarter of patients with migraine were on preventive agents and, of them, one third needs to try different treatments. Triptans do not appear to be commonly used among patients in Taiwan during the time studied. Treatment algorithms and resource utilization need to be further analysed to understand patient care of migraine care in Taiwan.