OBJECTIVES: Identification of patient cohorts in administrative claims can rely on a variety of variables, including the presence of diagnoses and or prescriptions. In some cases, patients with a prescription fill do not have evidence of the indicated diagnosis. This exploratory analysis compared baseline characteristics of patients using CGRP mAbs with and without proximate migraine diagnoses to investigate the impact of relying on prescriptions to identify patient cohorts.

METHODS: Adults with a medical or pharmacy claim for CGRP mAbs in the MarketScan Commercial and Medicare Databases between 1/1/2020 and 12/31/2021 were identified. The first CGRP mAbs claim was considered the index date. Patients were required to have 12 months of continuous enrollment in the database with medical and pharmacy benefits prior to the index date (baseline period). Those with evidence of pregnancy in the baseline period were excluded. Patient demographic and baseline clinical characteristics were compared between patients with and without a migraine diagnosis during the baseline period.

RESULTS: 53,909 patients treated with CGRP mAbs were included in the analysis. Most patients (93%) had a diagnosis of migraine during the baseline period. Age, regional distribution, and insurance plan type were similar in patients with and without a migraine diagnosis (SMD <10 for all). Comorbidity scores and presence of comorbid conditions during the baseline period were also similar in patients with and without a diagnosis of migraine during baseline (SMD <10 for all). However, a higher proportion of patients without a migraine diagnosis during baseline were male (26.6% vs. 13.6%; SMD: 32.89).

CONCLUSIONS: The baseline demographic and clinical profile of patients treated with CGRP mAbs is similar in patients with and without a migraine diagnosis. Treatment with CGRP mAbs may be considered when developing claims-based algorithms to identify patients with migraine, particularly when statistical power is a concern or study population size is limited.