A Dutch cost-effectiveness analysis of fremanezumab versus best supportive care in patients with chronic migraine and inadequate response to prior preventive therapy.

Autor: Wolters S; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands. sharon@ascacademics.com.; Asc Academics B.V., Hereweg 120, Groningen, 9725 AK, The Netherlands. sharon@ascacademics.com., Carpay JA; The Migraine Clinic, Mariotteplein 60, Amsterdam, 1098 PA, The Netherlands., Pronk MH; MH Pronk Health Care Consultancy Foundation, Leidsestraatweg, Woerden, 41D, 3443 BP, The Netherlands., Zuurbier KWM; Teva Netherlands B.V., Swensweg 5, Haarlem, 2031 GA, The Netherlands., Driessen MT; Teva Pharmaceuticals, Piet Heinkade 107, Amsterdam, 1019 BR, The Netherlands., Lyras L; Teva Pharmaceuticals, Piet Heinkade 107, Amsterdam, 1019 BR, The Netherlands., Postma MJ; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.; Department of Economics, Econometrics and Finance, University of Groningen, Antonius Deusinglaan 1, Groningen, 9713 AV, The Netherlands.
Jazyk: angličtina
Zdroj: BMC neurology [BMC Neurol] 2024 Jun 24; Vol. 24 (1), pp. 214. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1186/s12883-024-03697-x
Abstrakt: Background: Chronic migraine (CM) is the most severe and burdensome subtype of migraine. Fremanezumab is a monoclonal antibody that targets the calcitonin gene-related peptide pathway as a migraine preventive therapy. This study aimed to conduct a cost-effectiveness analysis of fremanezumab from a societal perspective in the Netherlands, using a Markov cohort simulation model.
Methods: The base-case cost-effectiveness analysis adhered to the Netherlands Authority guidelines. Fremanezumab was compared with best supportive care (BSC; acute migraine treatment only) in patients with CM and an inadequate response to topiramate or valproate and onabotulinumtoxinA (Dutch patient group [DPG]). A supportive analysis was conducted in the broader group of CM patients with prior inadequate response to 2-4 different classes of migraine preventive treatments. One-way sensitivity, probabilistic sensitivity, and scenario analyses were conducted.
Results: Over a lifetime horizon, fremanezumab is cost saving compared with BSC in the DPG (saving of €2514 per patient) and led to an increase of 1.45 quality-adjusted life-years (QALYs). In the broader supportive analysis, fremanezumab was cost effective compared with BSC, with an incremental cost-effectiveness ratio of €2547/QALY gained. Fremanezumab remained cost effective in all sensitivity and scenario analyses.
Conclusion: In comparison to BSC, fremanezumab is cost saving in the DPG and cost effective in the broader population.
(© 2024. The Author(s).)
Databáze: MEDLINE
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