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Pharmaco-Economic Effect of Botulinum Type A (BTX-A)
on the Difficult to Manage Headache Patient
A Blumenfeld, J Mazaira, M. Tischio, J Lynch
Posted: March 2003  
Headache Quarterly 2002; 13.3:29


Objective:   To decrease triptan costs in 50 headache patients utilizing botulinum toxin type A (BTX-A) injections for headache prophylaxis.

Design:   A retrospective analysis of 50 patients using significant doses of triptans without prophylactic treatment was conducted over a 6-month period through pharmacy records. Significant triptan use was defined as greater than 36 oral doses, eight parenteral, or 24 nasal doses over a 6-month period. All patients were enrolled in a comprehensive headache management program. Prophylactic treatment was initiated in all 50 patients as follows: BTX-A treatment only (group 1) and combined oral and BTX-A treatment (group 2). Data were analyzed for treatment costs from pharmacy records for both groups. Costs were calculated for 6 months prior to BTX-A treatment compared to 6 months after first BTX-A treatment.

Outcome Measures:   The average annualized savings in pharmacy cost for group 1 was $946 per patient and for group 2 was $338 per patient. These savings reflect a decrease in the number of triptans used.

Conclusion:   This analysis supports that triptan costs can be reduced using BTX-A as a prophylactic agent. Patients had less acute headaches as a result of BTX-A treatment; however, even when BTX-A costs are included there are additional pharmacy savings. These results support the effectiveness of BTX-A in patients who over-utilize triptans.