OBJECTIVES: Preventing migraine progression is relevant for health systems due to the individual and social costs attached. Therefore, we assessed the cost-effectiveness and cost-utility of Erenumab Vs Topiramate prophylaxis in patients with Episodic Migraine (EM).

METHODS: Through a Markov Chain Model with quarterly cycles, clinical stages of individuals with EM were simulated over a time horizon of five years (TH-5y). Effectiveness was estimated as monthly migraine-free days and utility as quality-adjusted life-years (QALYs) using data about randomized clinical trials and costs estimated (COP$) from the Colombian Health System. A sensitivity analysis was implemented applying a discount rate of 5%.

RESULTS: For the base case analyzed, Erenumab was dominated in cost per migraine-free days avoided, and the cost-utility ratio was 568 million per QALY. Erenumab gained 0.246 QALYs over HT-5y analyzed, 88.6% of the iterations classified Erenumab as a cost-useful technology in the cost-utility plane.

CONCLUSIONS: In terms of cost-effectiveness, the treatment with subcutaneous Erenumab at 70-140 mg/month was dominated by oral topiramate at 50-100 mg/day; notwithstanding, in terms of utility, Erenumab provided on average nearly four months of Quality of Life to patients with EM, although its cost-utility ratio would require a better price to make it a favorable option for Colombian Health System.