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Patient Preferences in Migraine Treatments
Headache; ePub 2019 Mar 12; Mansfield, et al
In a web-based discrete-choice experiment survey, patients who self-reported having ≥6 migraine days/month indicated that they may be willing to trade off efficacy in preventive migraine medicine for better adverse event (AE) profiles and a more favorable mode of administration. 300 respondents were offered choices between pairs of hypothetical preventive migraine medicines. Six attributes, each with 3 levels, defined the medicines: reduction in headache per month, frequency of limitations with physical activities, cognition problems, weight gain, how the medicine is taken, and monthly out-of-pocket cost. Researchers found:
- 72% of respondents indicated that migraines make physical activities difficult all or most of the time, and 81% had taken a prescription medicine to prevent migraine in the last 6 months.
- Respondents valued a change from a 10% reduction in migraine days to a 50% reduction more highly than avoiding the worst levels of AEs but were willing to trade off efficacy for less-severe AEs.
- Avoiding a 10% weight gain was more important than avoiding memory problems.
- Respondents preferred a once-monthly injection or daily pill to twice-monthly injection.
Mansfield C, Gebben DJ, Sutphin J, et al. Patient preferences for preventive migraine treatments: A discrete-choice experiment. [Published online ahead of print March 12, 2019]. Headache. doi:10.1111/head.13498.