Reduction of Medication Costs After Detoxification for Medication-Overuse Headache

Objective To examine whether detoxifying patients with medication-overuse headache can reduce long-term medication costs. Background Direct costs of medications in medication-overuse headache have been reported to be very high but have never been calculated on the basis of exact register data. Long-term economic savings obtained by detoxification have never been investigated. Methods We conducted a registry-based observational retrospective follow-up study on 336 medication-overuse headache patients treated and discharged from the Danish Headache Center over a 2-year period. By means of the Danish Register of Medicinal Product Statistics, we collected information on the costs and use of prescription-only medication 1 year before admission and 1 year after discharge from Danish Headache Center. Results The average medication costs per patient per year decreased with 24%, from US$971 before treatment to US$737 after (P=.001), and the average medication use decreased with 14.4% (P=.02). Savings were most pronounced for patients overusing triptans. In this group, the average medication costs per patient per year decreased with 43% (P<.001), while the average triptan use decreased with 38% (P<.001). Conclusions The study demonstrates that detoxification of medication-overuse headache at a tertiary headache center has a long-lasting effect on the medication costs and use, in particular among patients overusing triptans. The results may not be generalizable to all countries and may be sensitive to the costs of triptans.