Ronan Mahon1, Andrea Lang2, Pamela Vo3, Jasper Huels4, Philip Cooney5, Andriy Danyliv5, Umakanth Vudumula6, Sreelatha Vadapalle6, Farooq Maniyar7, Peter J Goadsby8. 1. Value and Access, Novartis Ireland Limited, Dublin, Ireland. ronan.mahon@novartis.com. 2. Market Access, Novartis Sverige AB, Kista, Sweden. 3. Global Patient Access, Novartis Pharma AG, Basel, Switzerland. 4. WW Market Access and HEOR, Novartis Pharma AG, Basel, Switzerland. 5. Value and Access, Novartis Ireland Limited, Dublin, Ireland. 6. Value and Access, Novartis Healthcare Private Limited, Hyderabad, India. 7. Basildon and Thurrock University Hospitals and Queen Mary University, London, UK. 8. NIHR-Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre, King's College London, London, UK.
Abstract
BACKGROUND: Migraine is a common neurological disease that disproportionately affects females and has a peak incidence during productive years, resulting in significant burden. OBJECTIVE: The aim of the study was to determine the cost effectiveness of erenumab for the preventive treatment of migraine. METHODS: A hybrid decision-tree plus Markov model was developed to evaluate the cost effectiveness of erenumab as a migraine treatment compared with best supportive care only for patients experiencing at least 4 monthly migraine days for whom at least two prior preventive treatments had failed. Clinical efficacy data were based on results from four randomized controlled trials of erenumab against placebo. The primary outcomes were costs, migraine days, and quality-adjusted life-years (QALYs). An incremental cost-effectiveness ratio (ICER) was estimated as the cost per QALY gained. The cost per migraine day avoided was also estimated, as were disaggregated direct and indirect costs. The analysis was conducted from Swedish societal and healthcare system perspectives based on total migraine, chronic migraine and episodic migraine populations, using a discount rate of 3% applied to both costs and health benefits and using year 2019 values. RESULTS: In the base-case deterministic analyses, erenumab treatment resulted in ICERs of Swedish krona (SEK) 34,696 (€3310) and SEK301,565 (€28,769) per QALY gained in the total migraine and episodic migraine populations, respectively. Erenumab was dominant in the chronic migraine population. In the total migraine population, the use of erenumab resulted in a net benefit to society of SEK81,739 (€7773) per patient, assuming a willingness-to-pay threshold of SEK300,000 (€28,528) per QALY. CONCLUSIONS: Our analysis suggests that erenumab is a cost-effective treatment for migraine with a willingness-to-pay threshold of SEK300,000 per QALY.
BACKGROUND:Migraine is a common neurological disease that disproportionately affects females and has a peak incidence during productive years, resulting in significant burden. OBJECTIVE: The aim of the study was to determine the cost effectiveness of erenumab for the preventive treatment of migraine. METHODS: A hybrid decision-tree plus Markov model was developed to evaluate the cost effectiveness of erenumab as a migraine treatment compared with best supportive care only for patients experiencing at least 4 monthly migraine days for whom at least two prior preventive treatments had failed. Clinical efficacy data were based on results from four randomized controlled trials of erenumab against placebo. The primary outcomes were costs, migraine days, and quality-adjusted life-years (QALYs). An incremental cost-effectiveness ratio (ICER) was estimated as the cost per QALY gained. The cost per migraine day avoided was also estimated, as were disaggregated direct and indirect costs. The analysis was conducted from Swedish societal and healthcare system perspectives based on total migraine, chronic migraine and episodic migraine populations, using a discount rate of 3% applied to both costs and health benefits and using year 2019 values. RESULTS: In the base-case deterministic analyses, erenumab treatment resulted in ICERs of Swedish krona (SEK) 34,696 (€3310) and SEK301,565 (€28,769) per QALY gained in the total migraine and episodic migraine populations, respectively. Erenumab was dominant in the chronic migraine population. In the total migraine population, the use of erenumab resulted in a net benefit to society of SEK81,739 (€7773) per patient, assuming a willingness-to-pay threshold of SEK300,000 (€28,528) per QALY. CONCLUSIONS: Our analysis suggests that erenumab is a cost-effective treatment for migraine with a willingness-to-pay threshold of SEK300,000 per QALY.
Authors: M Linde; A Gustavsson; L J Stovner; T J Steiner; J Barré; Z Katsarava; J M Lainez; C Lampl; M Lantéri-Minet; D Rastenyte; E Ruiz de la Torre; C Tassorelli; C Andrée Journal: Eur J Neurol Date: 2011-12-05 Impact factor: 6.089
Authors: Krista A Payne; Sepideh F Varon; Ariane K Kawata; Karen Yeomans; Teresa K Wilcox; Aubrey Manack; Dawn C Buse; Richard B Lipton; Peter J Goadsby; Andrew M Blumenfeld Journal: Cephalalgia Date: 2011-06-20 Impact factor: 6.292
Authors: Richard B Lipton; Aubrey Manack Adams; Dawn C Buse; Kristina M Fanning; Michael L Reed Journal: Headache Date: 2016-06-28 Impact factor: 5.887