OBJECTIVES: To estimate the size of the migraine population currently treated with preventive therapy in the US, and describe patterns of use for migraine preventive medication.

METHODS: We identified continuously enrolled migraine patients at least 18 years of age in the Truven Health MarketScan® Research Databases between January 1, 2012 and December 31, 2014 and described their prophylactic treatment for migraine in 2014. People with migraine (PWM) were identified using a claims-based algorithm consisting of the migraine ICD-9 code 346.xx and one or more acute migraine-specific therapies (triptan or ergot-derivative). Those with evidence of epilepsy were excluded. Use of migraine preventive therapies (antiepileptic agents, beta-blockers, calcium channel blockers, anti-depressants, and other medications) was assessed using prescription claims. Indication for preventive medications was assigned based on proximity of diagnosis codes to the prescription fill, and only fills with an indication of migraine were included in the analysis. Patients were classified based on the number of distinct prescription preventive treatments for migraine they had received in the look-back period from January 1, 2012 until the most recent preventive therapy fill date.

RESULTS: Approximately 359,000 PWM were identified in the MarketScan® database. Eighty-two percent were women, and 73% were between the ages 30-59 years. Overall, 34% (n=122,128) of PWM were currently using a preventive migraine therapy. Women were more likely than men to receive prevention. Among PWM on prevention 55% were on their initial therapy, 27% were on their 2nd therapy, 11% were on 3rd-therapy and 7% were on 4th preventive or higher.

CONCLUSIONS: Using diagnostic and treatment data to identify migraine, just over one third of PWM were also prescribed a preventive treatment. Many individuals who receive preventive medications for migraine cycle through multiple therapies. These estimates are higher than previous studies because of restriction to persons with medically diagnosed migraine.