Cost‐Effectiveness of Antiepileptic Drugs in Migraine Prophylaxis

Abstract

Antiepileptic drugs have proven effectiveness in migraine prophylaxis. However, in patients responsive to their acute care medications, the antiepileptic drugs are only cost-effective for those patients with a high frequency of migraines and those with comorbid diseases. Future studies should be done with antiepileptic drugs in patients exhibiting a migraine frequency of 10 or more headaches per month.

Unmet Needs in the Treatment of Allergic Asthma: Potential Role of Novel Biologic Therapies

“…Following consultation with the specialist, there was a 45% decrease in the number of office visits for asthma, a 55% decrease in acute care visits, a 67% decrease in hospitalizations, and a cost savings of $2,100 per patient. 56 Similar findings were reported by Wu et al, 57 who conducted a survey of asthma outcomes among 1954 adult asthma patients treated either by a specialist or generalist. Compared with patients treated by generalists, patients treated by an allergist reported fewer cancelled activities, hospitalizations, and ED visits and greater physical functioning.…”

“…Patients treated by pulmonologists reported that their symptom control was improved compared with those treated by generalists. 57 Frieri et al 58 reported that asthma patients evaluated by allergists had more severe disease and thus had more office visits and were prescribed more medications than those seen by a primary care physician. However, it was also noted that, despite the increased cost to treat the more severe patients, their care was more closely aligned with the NAEPP treatment guidelines.…”

Topiramate: the evidence for its therapeutic value in the prevention of migraine

“…These studies indicated that topiramate 100 mg/day and 200 mg/day appear to have equivalent effectiveness, which may indicate that the dose of 200 mg/day used by Adelman et al (2002) may not be the most appropriate. Reanalyzing the data using the efficacy results from the large recent trials and at the 100 mg/dose would provide important evidence.…”

Examination of the Evidence for Off-Label Use of Gabapentin

“…They reported that divalproex patients must have more than 10 migraine episodes per month while gabapentin patients must have more than 24 migraine episodes per month before these drugs can be considered cost effective. [57][58][59][60] While there are clinical trials of gabapentin in migraine prophylaxis, outstanding questions remain regarding the drug' s utility in clinical practice. One randomized, placebo-controlled study of 63 patients showed that gabapentin in daily prophylactic doses of 1,200 mg is well tolerated and reduces headache frequency and the use of drugs to produce symptomatic relief.…”