Real-world utilization of acute treatments for cluster headache: Insights from the French National Open Health Data.

BACKGROUND

The utilization of open health databases offers a unique opportunity to analyze the dispensing of healthcare products within real-world populations. A recent study by Van Obberghen et al. (2025) was the first to leverage the French national database to examine consumption volumes for cluster headache (CH) treatments, with a specific focus on the sex ratio. Nonetheless, further investigation into additional variables - such as seasonality and geographical distribution - is warranted, given the well-established role of chronobiology in the pathophysiology of CH.

OBJECTIVES

The primary objective of this study was to characterize the clinical expression of CH using real-world healthcare data, specifically assessing the influence of gender, age, and temporal-spatial factors. Additionally, we aimed to quantify the evolving economic burden of CH treatments at the national level.

METHODS

A retrospective analysis was conducted using the French national health database (2014-2024). We extracted dispensing records for subcutaneous sumatriptan (SS) and oxygen therapy (OT), the two validated acute treatments for CH. These patterns were analyzed across demographic groups and administrative regions, with statistical correlations performed against climatic (sunshine, rainfall), demographic, and economic variables.

RESULTS

Between 2014 and 2024, the total expenditure for OT in CH tripled, while SS costs increased only 1.6-fold. A consistent decrease in the male-to-female sex ratio was observed across all age groups for both treatments. This decline was statistically significant in all three age groups over 20 years of age for OT delivery, and in the two age groups between 20 and 59 years for SS delivery. A distinct peak in SS dispensing was observed in July; however, no statistically significant associations were found between SS dispensing and sunshine or rainfall. Younger men exhibited significantly higher consumption than older men, and overall consumption remained higher in men than in women.

CONCLUSIONS

Our findings highlight evolving treatment patterns and a shifting sex ratio in the delivery of CH therapies among treated patients. While no clear environmental drivers of treatment use were identified, the study underscores the value of open health data in monitoring prescribing trends and evaluating the economic impact of CH therapies.