Cost-Effectiveness of Erenumab for the Preventive Treatment of Migraine in Patients with Prior Treatment Failures in Sweden

Mahon, R; Lang, A; Vo, Pamela; Huels, Jasper; Cooney, Philip; Danyliv, Andriy; Vudumula, Umakanth; Vadapalle, Sreelatha; Maniyar, Farooq; Goadsby, PJ

doi:10.1007/s40273-020-00996-2

Cited by 22 publications

(39 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One of the major drawbacks of the anti‐CGRP pathway mAbs is their high cost. So far, only one study has assessed the cost‐effectiveness of mAbs (specifically erenumab, in Sweden) with positive findings [42]. However, optimizing patients' selection would undoubtedly increase the costs/savings ratio.…”

Section: Discussionmentioning

confidence: 99%

Rapid response to galcanezumab and predictive factors in chronic migraine patients: A 3‐month observational, longitudinal, cohort, multicenter, Italian real‐life study

Vernieri

Altamura

Brunelli

et al. 2021

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Rapid response to galcanezumab and predictive factors in chronic migraine patients: A 3‐month observational, longitudinal, cohort, multicenter, Italian real‐life study

Vernieri

Altamura

Brunelli

et al. 2021

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…However, the high cost of the mAb primarily limits their wide and prolonged use. Preliminary economics evaluations predicted that erenumab is also likely to reduce migraine-related direct and indirect costs compared to standard care [ 36 ]. Hence, a comprehensive economic evaluation comparing the CGRP pathway targeted mAb to standard care is thus necessary to clarify these aspects to guide regulatory drug agencies.…”

Section: Discussionmentioning

confidence: 99%

Conversion from chronic to episodic migraine in patients treated with galcanezumab in real life in Italy: the 12-month observational, longitudinal, cohort multicenter GARLIT experience

et al. 2022

View full text Add to dashboard Cite

Objective To investigate in real-life the conversion from chronic migraine (CM) to episodic migraine (EM), specifically to EM with High-Frequency (HFEM: 8–14 monthly migraine days, MMDs), Medium-Frequency (MFEM, 4–7 MMDs), and Low-Frequency EM (LFEM, 0–3 MMDs), and its persistence during 1 year of treatment with galcanezumab. Methods Consecutive CM patients treated with galcanezumab completing 1 year of observation were enrolled. We collected data on MMDs, pain intensity (Numeric Rating Scale, NRS score), and monthly acute medication intake (MAMI) from baseline (V1) to the 12-month visit (V12). Results Of the 155 enrolled patients, 116 (around 75%) reverted to EM at every visit and 81 (52.3%) for the entire 1-year treatment. Patients with older onset age ( p = 0.010) and fewer baseline MMDs ( p = 0.005) reverted more frequently to EM. At V12, 83 participants (53.5%) presented MFEM or LFEM. Patients reverted to MFEM or LFEM for 7 months (25th 1, 75th 11). The medication overuse discontinuation rate at V12 was 82.8% and occurred for 11 months (25th 8, 75th 12). From baseline to V12, the MAMI decreased by 17 symptomatic drugs ( p < 0.000001) while the NRS score reduced by almost 2 points ( p < 0.000001). A consistent transition to EM for the entire treatment year was observed in 81 (52.3%) patients. Discussion The 1-year GARLIT experience suggests that more than half of CM patients treated with galcanezumab persistently reverted to EM in real life. Trial registration ClinicalTrials.gov NCT04803513. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11226-4.

show abstract

“…The main issue on expanding the use of anti-CGRP treatments is the high cost of anti-CGRP mAbs, thus, the European and American guidelines recommended them only to those without other suitable or equally effective therapeutic options. 35 , 36 Recent cost-effectiveness analyses provided different results: a Swedish study showed that erenumab is cost-effective in patients with both episodic and chronic migraine, provided that they have 2 or more prior treatment failures; 69 a Greek study proved that erenumab cost-effectiveness is comparable to onaboulinumtoxinA in patients with chronic migraine; 70 a study performed in the US proved a greater cost-effectiveness of erenumab than onabotulinumtoxinA and hypothesized that treatment might be cost-effective even in episodic migraine prevention when considering loss of work productivity. 71 All studies were region-restricted, none performed a wider analysis including different countries and, thus, did not considered possible local differences in treatment and healthcare costs.…”

Section: Patient Profilesmentioning

confidence: 99%

“…Cost-effectiveness was estimated from RCTs data, where patients with more severe forms of disease were underrepresented; wider cost-effectiveness analyses including data from real-world might provide a different scenario enlarging the group of patients, who might most benefit from the treatment. 69–71 …”

Section: Patient Profilesmentioning

confidence: 99%

Migraine Prevention with Erenumab: Focus on Patient Selection, Perspectives and Outcomes

Sacco¹,

Ornello²

2022

TCRM

View full text Add to dashboard Cite

Erenumab is a monoclonal antibody targeting the calcitonin gene-related peptide (CGRP) receptor suitable for episodic and chronic migraine prevention. Randomized clinical trials proved the superiority of erenumab to placebo in a strictly selected population, while real-world studies confirmed treatment efficacy in more severe forms of disease – most patients suffered from chronic migraine with medication overuse headache, had prior treatment failures, and long disease duration. According to guidelines, anti-CGRP pathway monoclonal antibodies should be reserved to patients who failed or have contraindication to several classes of preventive treatments. However, their ease of use, tolerability and efficacy make these monoclonal antibodies ideally suitable for most patients with migraine; cost-effectiveness needs to be considered when looking at expanding current prescription criteria. Also, data from open label extensions of randomized control trials confirmed sustained benefits of prolonged treatment up to 5 consecutive years without significant risk of adverse events. Further studies will provide insights on optimal treatment duration to achieve migraine remission and predictors of treatment response. In the present work, we aimed at reviewing design and results of the main studies on erenumab and discussing treatment use in the current migraine prevention scenario; we also summarized the main ongoing research projects and provided clinical perspectives for the future.

show abstract

Cost-Effectiveness of Erenumab for the Preventive Treatment of Migraine in Patients with Prior Treatment Failures in Sweden

Cited by 22 publications

References 42 publications

Rapid response to galcanezumab and predictive factors in chronic migraine patients: A 3‐month observational, longitudinal, cohort, multicenter, Italian real‐life study

Rapid response to galcanezumab and predictive factors in chronic migraine patients: A 3‐month observational, longitudinal, cohort, multicenter, Italian real‐life study

Conversion from chronic to episodic migraine in patients treated with galcanezumab in real life in Italy: the 12-month observational, longitudinal, cohort multicenter GARLIT experience

Migraine Prevention with Erenumab: Focus on Patient Selection, Perspectives and Outcomes

Contact Info

Product

Resources

About