Higher socioeconomic status is associated with dispensation of monoclonal antibodies against calcitonin gene-related peptide in migraine: A nested case-control study
Abstract
Background Higher socioeconomic status (SES) among people with migraine has been associated with an increased use of triptans, but it is undetermined whether high SES is also associated with dispensation of monoclonal antibodies against calcitonin gene-related peptide (CGRPi), a prophylactic treatment against migraine episodes. Our hypothesis was that higher SES is associated with CGRPi dispensation, although the association is expected to be attenuated in a country that generally allows for reimbursement of CGRPi costs. Methods In this register-based nested case-control study, the association between SES, categorized into three levels (low, middle and high) and the outcome of a first dispensation of a CGRPi was assessed among people with a migraine diagnosis in Region Stockholm, using univariable and multivariable logistic regression models. Results Of 52,996 individuals in the study population, 3.2% (n = 1674) were dispensed CGRPi. Individuals with high or middle SES had an increased probability of being dispensed CGRPi, compared to individuals with low SES (adjusted odds ratio = 1.68; 95% confidence interval = 1.46–1.92 and adjusted odds ratio = 1.41; 95% confidence interval = 1.24–1.61, respectively). Conclusions Higher SES was associated with dispensation of CGRPi, which suggests unequal access to CGRPi. Graphical abstract This is a visual representation of the abstract.
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 52,996 participants or records.
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