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| |  AHS: Botox (Botulinum Toxin Type A) Cuts Headache Treatment Costs By Bruce Sylvester Special to DG News SEATTLE, WA -- June 22, 2002 -- Injections of Botox (botulinum toxin type A) not only prevent severe chronic headaches and migraines in a majority of sufferers, but they are less expensive than other drugs currently in use, researchers reported at the annual meeting of the American Headache Society. "We looked at a group of patients using our managed-care program," said Andrew Blumenfeld, chief neurologist at The Kaiser Permanente Health System in San Diego, California. "We used our in-house records to examine their pharmacy costs in the six-months prior to the initiation of Botox treatment. We compared these figures to the cost of six months of Botox treatment. We found that Botox cost less." Dr. Blumenfeld and his research team enrolled 50 subjects from the Kaiser Managed Care Plan who had been identified by Kaiser pharmacists as being frequent users of triptans, the most widely prescribed class of drugs for severe chronic headache and migraine. In order to lower treatment costs to the plan, pharmacists referred these patients to the Kaiser neurology department for a comprehensive headache management program and Botox injections. Thirty-one of the 50 subjects suffered from mixed-type headache caused by migraine, tension and overuse of medications. Eight suffered from migraines only. Eight had chronic tension headaches. One had severe headaches identified with overuse of medications. Two had headaches of unknown origin. All subjects received two sets of Botox injections, at the start of the trial and at three months, at a dose range of 35-90 U. Since the effect of a set of injections lasts for three months, two sets covered the six-month active-treatment period of the trial. The investigators administered the injections at sites on the face, head and neck, which were identified by each patient as regions of greatest pain and discomfort. After six-month, mean and median pre-treatment total pharmacy costs were $1020.25 US and 852.12 US, respectively, compared to $748.08 US and $628.23 US for post-treatment costs (p<0.0001). There was a mean reduction in total pharmacy costs of $272.17 US and median reduction of $281.05 US. - a 27-33 percent reduction for the six month period. "This will have large implications for managed-care organizations," Dr. Blumenfeld said. "Not only do we have patients who feel better. We can see that from this study and we have seen it in other studies. But we also have a situation where treatment costs for millions of people can go down instead of up. It’s a win-win situation for the patient and for cost-control in managed care.
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