{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T15:55:41Z","timestamp":1770134141493,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T00:00:00Z","timestamp":1412812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Headache"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine whether the utilization of healthcare resources is reduced after chronic migraine patients are treated for 6 months with onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      is indicated for headache prophylaxis in patients with chronic migraine, but its effect on healthcare resource use is unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from an open\u2010label study of 230 chronic migraine patients refractory to \u22652 oral prophylactics who presented to a headache specialty clinic and who were treated with two cycles of onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      . Frequency and cost of migraine\u2010related healthcare resource use, including visits to emergency departments, urgent care, or hospitalization, were compared for the 6 months before and after initial treatment. Costs were based on publicly available sources.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with the 6 months predating initial treatment, patients had 55% fewer emergency department visits (174 vs 385), 59% fewer urgent care visits (61 vs 150), and 57% fewer hospitalizations (19 vs 45) during the 6\u2010month treatment period (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01 for all). Analysis of treatment\u2010related costs yielded an average reduction of $1219.33\/patient, off\u2010setting 49.7% of the total estimated cost for 6 months of treatment with onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Although we are unable to distinguish onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      's treatment effect from other potential confounding variables, our analysis showed that severely afflicted, treatment\u2010refractory patients with chronic migraine experienced a significant cost\u2010offset through reduced migraine\u2010related emergency department visits, urgent care visits, and hospitalizations in the 6 months following treatment initiation of onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      . Future analyses will assess the longer\u2010term effect of onabotulinumtoxin\n                      <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>\n                      treatment and the potential contribution of regression to the mean.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.12456","type":"journal-article","created":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T01:15:36Z","timestamp":1412817336000},"page":"1565-1573","source":"Crossref","is-referenced-by-count":39,"title":["Real\u2010World Economic Impact of Onabotulinumtoxin\n                    <scp>A<\/scp>\n                    in Patients With Chronic Migraine"],"prefix":"10.1111","volume":"54","author":[{"given":"John F.","family":"Rothrock","sequence":"first","affiliation":[{"name":"Department of Neurology Renown Neurosciences Institute  Reno NV USA"},{"name":"Division of Neurosciences University of Nevada\/Reno School of Medicine  Reno NV USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Bloudek","sequence":"additional","affiliation":[{"name":"Xcenda, LLC  Palm Harbor FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy T.","family":"Houle","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wake Forest University School of Medicine  Winston\u2010Salem NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Andress\u2010Rothrock","sequence":"additional","affiliation":[{"name":"Division of Neurosciences University of Nevada\/Reno School of Medicine  Reno NV USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepideh F.","family":"Varon","sequence":"additional","affiliation":[{"name":"Allergan, Inc.  Irvine CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2012.02223.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2009.01941.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2009.01369.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.01945.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410364676"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410364677"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01678.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318232ab65"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.01990.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2005.00878.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.suppl_1.S20"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410381145"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01766.x"},{"key":"e_1_2_9_15_1","unstructured":"Medicare Payment Advisory Commission.Report to the Congress: Medicare payment policy. 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