COST-EFFECTIVENESS ANALYSIS OF ERENUMAB FOR THE PROPHYLACTIC TREATMENT OF EPISODIC AND CHRONIC MIGRAINE ON PRIVATE HEALTH INSTITUTIONS IN MEXICO.
Author(s)
Gomar D1, Tierrablanca L2, Botello BS3, Gonzalez LA3
1Novartis Farmaceútica S.A. de C.V., Mexico, MEX, Mexico, 2Novartis Farmaceútica S.A. de C.V., CDMX, MEX, Mexico, 3Novartis Farmaceútica S.A. de C.V., CDMX, Mexico
Presentation Documents
OBJECTIVES: To assess the cost-effectiveness of erenumab 70mg for the prophylactic treatment of episodic and chronic migraine in private health institutions in Mexico. METHODS: A hybrid decision tree and Markov cohort model was constructed to evaluate erenumab among adult patients with episodic and chronic migraine who failed two prior preventive therapies. A comparison was made against no preventive treatment and onabotulinumtoxinA in episodic and chronic migraine, respectively. Only direct medical costs (drug utilization, administration cost and disease management) were considered in the analysis. Data inputs were extracted from published literature, clinical experts’ consultations and market research. Costs and benefits were discounted at 5%. Quarterly cycles were used in a time horizon of 10 years. The primary outcomes included accumulated costs, migraine days occurred and the incremental cost-effectiveness ratio presented as cost per averted migraine day. Sensitivity analyses were performed to assess the robustness of the model estimations. RESULTS: The management of episodic and chronic migraine with erenumab was associated with a reduction of 160 and 226 days with migraine over 10 years, respectively. Treatment with erenumab in the private payer perspective had an incremental cost-effectiveness ratio of MXN 739.35 and MXN 561.83 versus no preventive treatment and onabotulinumtoxinA in episodic and chronic migraine, respectively. Model results were sensitive to the cost per migraine day and treatment costs. Probabilistic sensibility analysis demonstrated erenumab was cost-effective in 100% of the simulations, assuming a willingness-to-pay threshold of MXN 188,974 (1 GDP per capita) for both cohorts. CONCLUSIONS: The use of erenumab is a cost-effective approach for preventing monthly migraine days among patients with chronic migraine versus onabotulinumtoxin A and no preventive treatment among patients with episodic migraine in the Mexican private health care context.
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PND28
Topic
Economic Evaluation, Health Policy & Regulatory, Methodological & Statistical Research
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis, Reimbursement & Access Policy
Disease
Drugs, Neurological Disorders