Cost-effectiveness of almotriptan and rizatriptan in the treatment of acute migraine

Williams, Paul; Reeder, C. E.

doi:10.1016/s0149-2918(03)80344-2

Cited by 21 publications

(24 citation statements)

References 9 publications

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“…However, this outcome was generally ignored in the economic evaluation studies comparing the cost-effectiveness of acute medications except for two studies. 15, 19 It is well known that tolerability can also have a substantial impact on compliance and treatment outcome. Gallagher and Kunkel 38 reported that 71% of migraine sufferers delayed or avoided taking medications due to concerns about adverse events.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…For example, Williams et al 25 constructed a decision analytic model within a 1-year time horizon to simulate a controlled clinical trial in which patients with migraine receiving primary medical care were randomly assigned to treatment under a stepped-care or a stratified-care regimen. 19 Studies of acute medications usually adopted the time horizon of 24 hours or a certain number of migraine attacks, 23 whereas models in the studies evaluating the prophylaxis treatment usually allowed for a 1-year follow-up period. However, other than the choice of time horizon, it is also important for the model to have necessary components to represent the dynamics of the progression of migraine and the treatment response in the real world.…”

Section: Specification Of the Modelmentioning

confidence: 99%

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Economic Evaluation of Pharmacotherapy of Migraine Pain: A Review of the Literature

Goodman

Oderda

2009

Journal of Pain & Palliative Care Pharmacotherapy

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This paper reviews the economic evaluation literature on pharmacotherapy for migraine and identifies important trends and gaps in the literature. Given the tremendous economic burden of migraine and the availability of various therapies for migraine treatment, economic evaluation of alternative therapies plays a critical role in identifying the most cost-effective therapy to optimize health care resource allocation and clinical decisions. Particularly, physicians and clinical administrators are expected to take an active role in resource allocation decisions at the clinical level. Thus, it is important for them to be familiar with the economic evaluation in migraine pain management, and most importantly, methodologies of economic analyses and the associated shortcomings of published estimates. In this paper, the methodological characteristics of these studies are examined and their results are compared and interpreted. Alternative treatment and health outcome measures are defined and data sources described while methods for assessing the direct and indirect costs are explored. Directions for future research are identified and discussed.

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Section: Outcome Measuresmentioning

confidence: 99%

Section: Specification Of the Modelmentioning

confidence: 99%

Economic Evaluation of Pharmacotherapy of Migraine Pain: A Review of the Literature

Goodman

Oderda

2009

Journal of Pain & Palliative Care Pharmacotherapy

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“…In a move to capture both effi cacy and tolerability in a more well-defi ned and statistical way, a new endpoint has been proposed: sustained pain free with no adverse events (SNAE) [11,12] . This composite endpoint may represent even better what patients want from their migraine treatment.…”

Section: Incorporating Tolerability With Effi Cacy: Sustained Pain Frmentioning

confidence: 99%

Defining Response in Migraine: Which Endpoints Are Important?

Edmeads

2005

Eur Neurol

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The primary endpoint traditionally measured in clinical trials of triptans for acute migraine therapy has been 2-hour pain relief, a decrease in pain intensity from moderate/severe to mild/none. Although harder to achieve, endpoints such as 2-hour pain free and the composite measure sustained pain free are now preferred as they better reflect what patients desire from medication, namely rapid onset of action, and complete and lasting relief of pain. A comprehensive meta-analysis has shown that oral triptans differ in their ability to achieve these endpoints, with almotriptan 12.5 mg, eletriptan 80 mg and rizatriptan 10 mg providing the highest likelihood of success. Although all triptans have simple and consistent pharmacokinetic features, they also have specific differences that may play a part in their differing clinical attributes. Incorporating tolerability to generate a more stringent endpoint, sustained pain free with no adverse events (SNAE), may provide an even better representation of patients’ expectations. Comparison of SNAE rates using data from the meta-analysis of oral triptans indicates that almotriptan 12.5 mg has the best balance of high efficacy and good tolerability.

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“…Another used another composite endpoint of sustained freedom from pain and no adverse effects to compare almotriptan and sumatriptan [12]. The same authors published an almost identical comparison of almotriptan and rizatriptan [13]: both studies were funded by the manufacturers of almotriptan and both concluded that almotriptan was the more cost effective. Three more studies used meta-analyses of studies to compare indirectly a range of different triptans, but used the less rigorous two hour outcome [14][15][16].…”

Section: Cost Effectiveness Analysismentioning

confidence: 99%

Pharmacoeconomics for migraine and headache researchers: basic concepts, methods and terminology

Walley

2004

J Headache Pain

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Pharmacoeconomics, the application of health economics to pharmaceuticals, is an increasingly important part of the evaluation of any therapy. It is a response to limitations on the resources available for medical care, and the need to justify how we spend these resources for the public good. This review summarises some of the key issues in pharmacoeconomics, drawing examples from the literature on migraine or headaches. It describes how pharmacoeconomics is fundamentally comparative, and must be based on real world practice rather than on clinical trials. An important point is what outcomes in migraine might be used in such studies. The types of studies commonly encountered are detailed. These examples illustrate some of the limitations of the process: a risk of industry driven bias, and a draw of money into the areas evaluated (e. g., acute therapies) rather than those not considered (e. g., longterm therapies).

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Cost-effectiveness of almotriptan and rizatriptan in the treatment of acute migraine

Cited by 21 publications

References 9 publications

Economic Evaluation of Pharmacotherapy of Migraine Pain: A Review of the Literature

Economic Evaluation of Pharmacotherapy of Migraine Pain: A Review of the Literature

Defining Response in Migraine: Which Endpoints Are Important?

Pharmacoeconomics for migraine and headache researchers: basic concepts, methods and terminology

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