Skip to main content

Advertisement

SpringerLink
Log in

Comparative cost-effectiveness analysis of oral triptan therapy for migraine in four European countries

  • Original Paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Aim

To assess the differences in the cost-effectiveness of oral triptan therapy for migraines among European countries.

Methods

A cost-effectiveness analysis of triptan therapy for migraine was conducted from a health-care payer perspective in four European countries (France, Italy, Spain and the UK). The study included those orally administered triptans available in all of these countries (almotriptan, brand-name sumatriptan, generic sumatriptan, zolmitriptan), and it was performed using a decision-tree model that incorporated costs of the drugs and probabilities associated with the possible events and outcomes. Average cost-effectiveness ratios were calculated in two different scenarios.

Results

The average cost-effectiveness ratio showed wide variations across the different countries, these differences being up to 131 % (almotriptan), 77 % (brand-name sumatriptan), 153 % (generic sumatriptan) and 77 % (zolmitriptan). Generic sumatriptan was the most cost-effective drug analysed in the studied countries.

Conclusions

Caution must be taken when trying to transfer conclusions of pharmacoeconomics studies on migraines even in neighbouring countries. This cross-country variability is a concern for decision-makers and also for the elaboration of international recommendations and clinical practice guidelines.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Shrank, W.H., Joseph, G.J., Choudhry, N.K., Young, H.N., Ettner, S.L., Glassman, P., Asch, S.M., Kravitz, R.L.: Physicians’ perceptions of relevant prescription drug costs: do costs to the individual patient or to the population matter most? Am. J. Manag. Care 12, 545–551 (2006)

    PubMed  Google Scholar 

  2. Stewart, W.F., Lipton, R.B., Celentano, D.D., Reed, M.L.: Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA 267, 64–69 (1992)

    Article  CAS  PubMed  Google Scholar 

  3. Ferrari, M.D.: The economic burden of migraine to society. Pharmacoeconomics 13, 667–676 (1998)

    Article  CAS  PubMed  Google Scholar 

  4. Vinding, G.R., Zeeberg, P., Lyngberg, A., Nielsen, R.T., Jensen, R.: The burden of headache in a patient population from a specialized headache centre. Cephalalgia 27, 263–270 (2007)

    Article  CAS  PubMed  Google Scholar 

  5. Kernick, D.: An introduction to the basic principles of health economics for those involved in the development and delivery of headache care. Cephalalgia 25, 709–714 (2005)

    Article  CAS  PubMed  Google Scholar 

  6. Olesen, J., Gustavsson, A., Svensson, M., Wittchen, H.U., Jönsson, B., CDBE2010 study group, European Brain Council: The economic cost of brain disorders in Europe. Eur. J. Neurol. 19, 155–162 (2012)

    Article  CAS  PubMed  Google Scholar 

  7. Goldberg, L.D.: The cost of migraine and its treatment. Am. J. Manag. Care 11, S62–S67 (2005)

    PubMed  Google Scholar 

  8. Stovner, L.J., Andrée, C., Eurolight Steering Committee: Impact of headache in Europe: a review for the Eurolight project. J. Headache Pain 9, 139–146 (2008)

    Article  PubMed Central  PubMed  Google Scholar 

  9. Stovner, L., Hagen, K., Jensen, R., Katsarava, Z., Lipton, R., Scher, A., Steiner, T., Zwart, J.A.: The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 27, 193–210 (2007)

    Article  PubMed  Google Scholar 

  10. Johnston, M.M., Rapoport, A.M.: Triptans for the management of migraine. Drugs 70, 1505–1518 (2010)

    Article  CAS  PubMed  Google Scholar 

  11. Aukerman, G., Knutson, D., Miser, W.F.: Management of the acute migraine headache. Am. Fam. Physician 66, 2123–2130 (2002)

    PubMed  Google Scholar 

  12. Caro, J.J., Getsios, D.: Pharmacoeconomic evidence and considerations for triptan treatment of migraine. Expert Opin. Pharmacother. 3, 237–248 (2002)

    Article  PubMed  Google Scholar 

  13. Membe, S., McGahan, L., Cimon, K., Gawel, M., Giammarco, R., Mierzwinski-Urban, M.: Triptans for Acute Migraine: Comparative Clinical Effectiveness and Cost-Effectiveness [Technology Report No. 76]. Canadian Agency for Drugs and Technologies in Health, Ottawa (2007)

    Google Scholar 

  14. Barbieri, M., Drummond, M., Willke, R., Chancellor, J., Jolain, B., Towse, A.: Variabilty of cost-effectiveness estimates for pharmaceuticals in Western Europe: lessons for inferring generalizability. Value Health 8, 10–23 (2005)

    Article  PubMed  Google Scholar 

  15. Drummond, M., Barbieri, M., Cook, J., Glick, H.A., Lis, J., Malik, F., Reed, S.D., Rutten, F., Sculpher, M., Severens, J.: Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report. Value Health 12(4), 409–418 (2009)

    Article  PubMed  Google Scholar 

  16. European Commission: Directive 2001/83/EC of the European Parliament and of the council of 6 November 2001 on the community code relating to medicinal products for human use. Off. J. Eur. Comm. L 311, 67–128 (2004)

    Google Scholar 

  17. Garcia Arieta, A., Hernandez Garcia, C., Avendano Sola, C.: Directora Regulación de los medicamentos genéricos: evidencias y mitos. Inf. Ter. Sist. Nac. Salud. 34, 71–82 (2010)

    Google Scholar 

  18. Headache Classification Subcommittee of the International Headache Society: The international classification of headache disorders: 2nd edition. Cephalalgia 24(Suppl 1), 9–160 (2004)

    Google Scholar 

  19. Ramsberg, J., Henriksson, M.: The cost-effectiveness of oral triptan therapy in Sweden. Cephalalgia 27, 54–62 (2007)

    Article  CAS  PubMed  Google Scholar 

  20. Medicom Editorial S.A.: Vademecum Internacional, 50th ed. UBM Medica Ltd. http://www.vademecum.es/. Accessed 10 Jan 2012

  21. VIDAL: Le Dictionnaire VIDAL 2010. http://www.vidal.fr/. Accessed 10 Jan 2012

  22. Agenzia Italiana del Farmaco: Elenco farmaci autorizzati. http://farmaco.agenziafarmaco.it/index.php. Accessed 10 Jan 2012

  23. BMJ Group: British National Formulary, 58th edn. RPS Publishing, London (2009)

    Google Scholar 

  24. Exchange Rates. http://www.exchangerates.org.uk/GBP-EUR-exchange-rate-history.html. Accessed May 2013

  25. Adelman, J.U., Belsey, J.: Meta-analysis of oral triptan therapy for migraine: number needed to treat and relative cost to achieve relief within 2 hours. J. Manag. Care Pharm. 9, 45–52 (2003)

    PubMed  Google Scholar 

  26. Berdaï, D., Hotton, J.M., Lechat, P., Participates of Round Table no. 1 Giens XXV: Comparators (medicinal and non medicinal) for marketing authorization, for public health, for payers and at the European level. Therapie 65, 329–334 (2010)

    Article  PubMed  Google Scholar 

  27. Antonaci, F., Dumitrache, C., De Cillis, I., Allena, M.: A review of current European treatment guidelines for migraine. J. Headache Pain 11, 13–19 (2010)

    Article  PubMed Central  PubMed  Google Scholar 

  28. Grol, R., Eccles, M., Maisonneuve, H., Woolf, S.: Developing clinical practice guidelines. The European experience. Dis. Manag. Health Outcomes 4, 255–266 (1998)

    Article  Google Scholar 

  29. Lourenco, T., Grant, A., Burr, J., Vale, L.: Local decision-makers views’ of national guidance on interventional procedures in the UK. J. Health Serv. Res. Policy 15(Suppl 2), 3–11 (2010)

    Article  PubMed  Google Scholar 

  30. Evers, S., Afra, J., Frese, A., Goadsby, P.J., Linde, M., May, A., Sandor, P.S.: EFNS guideline on the drug treatment of migraine—revised report of an EFNS task force. Eur. J. Neurol. 16, 968–981 (2009)

    Article  CAS  PubMed  Google Scholar 

  31. Sculpher, M.: Evaluating the cost-effectiveness of interventions designed to increase the utilization of evidence-based guidelines. Fam. Pract. 17(Suppl 1), S26–S31 (2000)

    Article  PubMed  Google Scholar 

  32. Barbieri, M., Drummond, M., Rutten, F., Cook, J., Glick, H.A., Lis, J., Reed, S.D., Sculpher, M., Severens, J.L., ISPOR Good Research Practices Economic Data Transferability Task Force: What do international pharmacoeconomic guidelines say about economic data transferability? Value Health 13, 1028–1037 (2010)

    Article  PubMed  Google Scholar 

  33. Caro, J.J.: Current studies in pharmacoeconomics. Curr. Hypertens. Rep. 1, 475–476 (1999)

    Article  CAS  PubMed  Google Scholar 

  34. Welte, R., Feenstra, T., Jager, H., Leidl, R.: A decision chart for assessing and improving the transferability of economic evaluation results between countries. Pharmacoeconomics 22, 857–876 (2004)

    Article  PubMed  Google Scholar 

  35. Busse, R., Schreyögg, J., Smith, P.: Variability in healthcare treatment costs amongst nine EU countries—results from the Health BASKET project. Health Econ. 17, S1–S8 (2008)

    Article  PubMed  Google Scholar 

  36. Forchielli, F., Fusco, M., Pessina, E.A., Domeniconi, W., Ricciardi, W.: Study on Patient Mobility in the European Union. Study on Legislative Proposals on Patients’ Rights in Cross-Border Health Care. Analysis of the Proposal for a Directive of the European Parliament and of the Council on the application of patients’ rights in cross-border health {COM(2008) 414 final} and of the Communication from the Commission A Community framework on the application of patient’s rights in cross-border healthcare {COM(2008) 415 final}. Policy Department, Economic and Scientific Policy, European Parliament, Brussels (2008)

Download references

Acknowledgments

The authors would like to thank Prof. Antonio Inesta (Escuela Nacional de Sanidad) for his wise advice. This research received no specific Grants from any funding agencies in the public, commercial, or not-profit sectors.

Conflict of interest

The authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Rare Diseases Research Institute, Instituto de Salud Carlos III, Monforte de Lemos 5 (Pabellon 11), 28029, Madrid, Spain

    Manuel Hens, Ana Villaverde-Hueso, Veronica Alonso, Ignacio Abaitua & Manuel Posada de la Paz

  2. Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Madrid, Spain

    Veronica Alonso, Ignacio Abaitua & Manuel Posada de la Paz

Authors
  1. Manuel Hens
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ana Villaverde-Hueso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Veronica Alonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ignacio Abaitua
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Manuel Posada de la Paz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ana Villaverde-Hueso.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hens, M., Villaverde-Hueso, A., Alonso, V. et al. Comparative cost-effectiveness analysis of oral triptan therapy for migraine in four European countries. Eur J Health Econ 15, 433–437 (2014). https://doi.org/10.1007/s10198-013-0516-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-013-0516-x

Keywords

JEL Classification

Search

Navigation