Economic evaluations in migraine: systematic literature review and a novel approach

TY - JOUR

T1 - Economic evaluations in migraine

T2 - systematic literature review and a novel approach

AU - Mahon, Ronan

AU - Huels, Jasper

AU - Hacking, Victoria

AU - Cooney, Philip

AU - Danyliv, Andriy

AU - Vudumula, Umakanth

AU - Vadapalle, Sreelatha

AU - Vo, Pamela

AU - Maniyar, Farooq H.

AU - Palmer, Stephen

AU - Goadsby, Peter J.

N1 - Publisher Copyright: © 2020 Novartis Pharma AG. Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2020/8/2

Y1 - 2020/8/2

N2 - Background: For novel migraine therapies, economic evaluations will be required to understand the trade-offs between additional health benefit and additional cost. The purpose of this study was to conduct a systematic literature review (SLR) to identify previous economic evaluations in migraine from the United Kingdom or Irish perspective to critically appraise these evaluations and to propose, if necessary, a novel modelling approach that can be used for future economic evaluations of migraine therapies. Methods: An SLR was conducted to identify previous economic evaluations of preventive migraine treatments. Key opinion leaders were consulted to determine the criteria for a robust migraine economic evaluation. Economic evaluations identified in the SLR were appraised against these criteria, and a novel cost-effectiveness model structure was then proposed. Results: Eight records reporting on published economic evaluations were identified and critically appraised for general quality. Expert consultation provided 6 recommendations on the ideal model structure for migraine that is both clinically and economically meaningful. A decision-tree plus Markov structure was then developed as a cost-effectiveness model for migraine therapies where each health state is associated with a patient distribution across monthly migraine day (MMD) frequencies. Conclusions: Future migraine economic evaluations should allow for assessments across the full spectrum of migraine, a response-based stopping rule, and the estimation of benefits and resource costs based on MMD frequency. The approach proposed in this paper captures all of the desired elements for an economic evaluation of migraine therapy and is suitable to assess new migraine therapies.

AB - Background: For novel migraine therapies, economic evaluations will be required to understand the trade-offs between additional health benefit and additional cost. The purpose of this study was to conduct a systematic literature review (SLR) to identify previous economic evaluations in migraine from the United Kingdom or Irish perspective to critically appraise these evaluations and to propose, if necessary, a novel modelling approach that can be used for future economic evaluations of migraine therapies. Methods: An SLR was conducted to identify previous economic evaluations of preventive migraine treatments. Key opinion leaders were consulted to determine the criteria for a robust migraine economic evaluation. Economic evaluations identified in the SLR were appraised against these criteria, and a novel cost-effectiveness model structure was then proposed. Results: Eight records reporting on published economic evaluations were identified and critically appraised for general quality. Expert consultation provided 6 recommendations on the ideal model structure for migraine that is both clinically and economically meaningful. A decision-tree plus Markov structure was then developed as a cost-effectiveness model for migraine therapies where each health state is associated with a patient distribution across monthly migraine day (MMD) frequencies. Conclusions: Future migraine economic evaluations should allow for assessments across the full spectrum of migraine, a response-based stopping rule, and the estimation of benefits and resource costs based on MMD frequency. The approach proposed in this paper captures all of the desired elements for an economic evaluation of migraine therapy and is suitable to assess new migraine therapies.

KW - CGRP

KW - chronic migraine

KW - economic evaluation

KW - episodic migraine

KW - headache

KW - Model

KW - systematic literature review

UR - http://www.scopus.com/inward/record.url?scp=85084250455&partnerID=8YFLogxK

U2 - 10.1080/13696998.2020.1754840

DO - 10.1080/13696998.2020.1754840

M3 - Article

C2 - 32285724

AN - SCOPUS:85084250455

SN - 1369-6998

VL - 23

SP - 864

EP - 876

JO - Journal of Medical Economics

JF - Journal of Medical Economics

IS - 8

ER -