What is it about?
The annual economic burden of migraine in the US is high, with indirect costs due to lost productivity accounting for 36–56% of these costs among patients with episodic migraine and 40–70% of these costs among patients with chronic migraine. First-line preventive medications in episodic migraine have been associated with adverse events and suboptimal adherence rates (e.g. propranolol, topiramate); onabotulinumtoxinA was approved for the preventive treatment of chronic migraine and has been shown to be clinically efficacious and cost-effective in this indication. Cost-effectiveness analyses were conducted to compare a novel CGRP receptor (erenumab 140 mg) with no preventive treatment or onabotulinumtoxinA for the prophylactic treatment of episodic and chronic migraine in both the US societal and payer perspectives.
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Why is it important?
Our findings suggest that the use of erenumab may be a cost-effective approach to preventing monthly migraine days among patients with chronic migraine versus onabotulinumtoxinA and no preventive treatment in the societal and payer perspectives, but is less likely to offer good value for money for those with episodic migraine, unless lost productivity costs are considered.
Perspectives
In support of this manuscript, we designed and implemented a novel and robust cost-effectiveness model to assess the value of erenumab for the preventive treatment of episodic and chronic migraine. As more and more payers and providers in the US begin to rely on cost-effectiveness analyses to make formulary decisions, the results from this analysis should provide context for deeper discussions with industry stakeholders.
Matthew Sussman
Boston Health Economics Inc
Read the Original
This page is a summary of: Cost-effectiveness analysis of erenumab for the preventive treatment of episodic and chronic migraine: Results from the US societal and payer perspectives, Cephalalgia, August 2018, SAGE Publications,
DOI: 10.1177/0333102418796842.
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