PSY31 Economic Evaluation of Eletriptan 40mg for Migraine Therapy in Korea

Abstract

Migraine is a common central nervous system disorder. The burden of migraine is substantial due to its high prevalence and prominent temporary disability. This study investigates the application of cost-effectiveness analysis, from the Korean health care system perspective, for the comparison of eletriptan 40mg and sumatriptan 50mg in the acute treatment of migraine attack. A decision tree model was developed to estimate migraine treatment cost and efficacy. Clinical data was derived from a clinical trial comparing oral eletriptan to oral sumatriptan (G. Sandrini, 2002). Efficacy measures consisted of “pain-free at 2 hours (PF2)” and “sustained pain free for 2-24 hours (SPF)”. Drug costs for initial dosing, second dosing for relapse, physician visit cost, and emergency visit cost were taken into account. Citing 2008 HIRA report, physician visit cost and emergency visit cost were calculated. All costs converted into 2011 Korean Won (KRW). The time horizon was a single migraine attack. In the base-case analysis, assuming the eletriptan 40mg drug cost (4,775 KRW) is 20% higher than sumatriptan 50mg drug cost (3,979 KRW), the average cost-effectiveness ratio (ACER) were 23,702 KRW and 36,239 KRW (per attack at which PF2 is achieved) for eletriptan 40mg and sumatriptan 50mg, respectively. Also, ACER for SPF per attack is achieved was 26,054 KRW and 40,837 KRW for eletriptan 40mg and sumatriptan 50mg, respectively. Although eletriptan 40mg is more costly than sumatriptan 50mg, because of eletriptan 40mg's superior efficacy, the ACER of eletriptan 40mg was lower than sumatriptan 50mg in the treatment of migraine attack, with respect to PF2 and SPF aspects. Eletriptan 40mg has a potentially important role to play in the cost-effective management of migraine.