Peer Review History
| Original SubmissionDecember 8, 2023 |
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PONE-D-23-39933Healthcare resource utilization and associated costs among patients with migraine in Finland: A retrospective register-based studyPLOS ONE Dear Dr. Lahelma, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== ACADEMIC EDITOR: The manuscript has critical concerns to be dealth with. ============================== Please submit your revised manuscript by Mar 25 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript:
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Kind regards, Sercan Ergün Academic Editor PLOS ONE Journal Requirements: Additional Editor Comments (if provided): The manuscript has critical concerns to be dealth with. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: N/A ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The title is very appropriate, and the summary section covers the central aspect of the study. The introduction provides background and information relevant to the research and is very carefully written. The methods are transparent and replicable; all results match the described methods. While the results are not new, they represent progress in this area. The data is plausible. The findings described by the author correlate with the results, and the findings are relevant. The conclusions correlate to the results found. The authors have provided 5 figures and 2 tables; all are clear and legible. I think this article is precious and it would be useful to publish it in your journal. Reviewer #2: The authors present a retrospective, descriptive analysis of healthcare costs in patients diagnosed with or treated for migraines in a Finnish registry. The authors present two major conclusions: that healthcare costs associated with migraines are significant and likely correlated with disease severity, and that an earlier threshold for novel treatments may be warranted. The first conclusion is reasonably well-supported by the authors' findings, and is consequential to policy-makers in understanding resource utilization for migraines. One methodological question that could be further clarified relates to patients receiving preventive medications--the authors appear to identify prescriptions for antihypertensives, certain anticonvulsants, amitriptyline, and venlafaxine as preventive treatments for migraines within two weeks of a migraine billing code, although there does not appear to be an analysis of how many of these encounters (or patients) also had billing codes for hypertension, seizures, or mood disorders that could have influenced these prescriptions. Since these medications may well have been selected to address both migraines and a systemic comorbidity, these data points need not necessarily be eliminated, but further insights into potential confounding comorbidities would help the reader better understand the group requiring 3+ preventive medications, which is responsible for disproportionately high migraine-related and all-cause healthcare costs. Compared to the cohorts receiving triptans alone, the groups receiving preventive medications generally appear to have a greater proportion of patients aged 65+, which could again point to confounding from systemic comorbidities. The supporting evidence for the authors' second assertion regarding earlier use of novel therapies is less clear. The authors rightfully note the "unmet need in patients who have had inadequate response to two or more triptans" and show a modest increase in migraine-related healthcare costs in patients receiving multiple triptans, but omit a discussion regarding the very germane costs of CGRP antagonists as acute therapies for migraines. While these data are limited in episodic migraine, prior studies have suggested cost-effectiveness in chronic migraines only with steeply discounted drug prices (PMID 31302899) or in cohorts that had not responded to multiple prior treatments (PMID 36114468), which would weigh against early use of novel therapies. Moreover, the utility of CGRP antagonists in patients with contraindications to triptans (which had the second-largest healthcare expenditures in the study) remains uncertain given unresolved questions about the effects of CGRP blockade in ischemia. Should the authors wish to include a discussion on the role of novel therapies in episodic migraines, a more nuanced discussion of cost-effectiveness and an additional review of the literature would be appropriate. In terms of minor revisions: Line 52 - could be reworded for clarity (e.g., "noted an average of 5.9 doctor's visits per month over the preceding six months") Line 77 - "attack" may be a more recognizable term to readers than "seizure" Line 87 - blockade of the renin-angiotensin system appears to apply to antihypertensives rather than anticonvulsants, including in the listed reference Line 132 - "giant cell arteritis" might be recognizable to a broader audience than "Horton disease" Line 410 - as noted above, this observation in patients with likely chronic migraines may not apply to those with episodic migraines treated with triptans; additionally, it would be difficult to infer that CGRP antagonists led to a reduction in healthcare costs as the remaining patients on multiple preventive agents do not represent an adequate control group ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Bilgehan Atılgan ACAR Reviewer #2: No ********** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. |
| Revision 1 |
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Healthcare resource utilization and associated costs among patients with migraine in Finland: A retrospective register-based study PONE-D-23-39933R1 Dear Dr. Isomeri, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at http://www.editorialmanager.com/pone/ and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Sercan Ergün Academic Editor PLOS ONE Additional Editor Comments (optional): Revisions peformed by the authors are well. Revised manuscript is suitable for the publication. Reviewers' comments: |
| Formally Accepted |
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PONE-D-23-39933R1 PLOS ONE Dear Dr. Lahelma, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Sercan Ergün Academic Editor PLOS ONE |
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