International Journal of Technology Assessment in Health Care

ASSESSMENTS

COST-EFFECTIVENESS OF ORAL TRIPTANS FOR ACUTE MIGRAINE: MIXED TREATMENT COMPARISON

Christian Asseburga1, Piia Peuraa2, Tuija Oksanena3, Juha Turunena4, Timo Purmonena5 and Janne Martikainena6

a1 ESiOR Oy; School of Pharmacy, University of Eastern Finland email: christian.asseburg@esior.fi

a2 School of Pharmacy, University of Eastern Finland; Finnish Medicines Agency (Fimea)

a3 School of Pharmacy, University of Eastern Finland

a4 School of Pharmacy, University of Eastern Finland; Farenta Oy

a5 School of Pharmacy, University of Eastern Finland; Oy Medfiles Ltd.

a6 ESiOR Oy; School of Pharmacy, University of Eastern Finland

Abstract

Background: The cost-effectiveness of triptans in the treatment of migraine has not been assessed since generic sumatriptan entered the Finnish market in 2008.

Methods: Using systematic review and mixed treatment comparison, the effectiveness of triptans was estimated with regard to 2-hour response, 2-hour pain-free, recurrence, and any adverse event, using published clinical data. Direct and indirect costs (2010 EUR, societal perspective) and quality-adjusted life-years (QALYs) were evaluated over one acute migraine attack using a decision-tree model.

Results: The meta-analysis combined data from fifty-six publications. The highest probability of achieving the primary outcome, “sustained pain-free, no adverse event” (SNAE), was estimated for eletriptan 40 mg (20.9 percent). Sumatriptan 100 mg was the treatment with lowest estimated costs (€20.86), and the incremental cost-effectiveness ratio of eletriptan 40 mg compared with sumatriptan 100 mg was €43.65 per SNAE gained (€19,659 per QALY gained).

Conclusion: Depending on the decision-maker's willingness-to-pay threshold, either sumatriptan 100 mg or eletriptan 40 mg is likely to be cost-effective.

Keywords:

  • Triptans;
  • Migraine disorders;
  • Comparative effectiveness research;
  • Cost-benefit analysis;
  • Meta-analysis

Footnotes

  This study was conducted at the University of Eastern Finland and funded by the Finnish Medicines Agency. C.A. and J.M. are employed by ESiOR Oy, and J.M. holds shares in ESiOR Oy.