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A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point

OBJECTIVES: To use a composite efficacy/tolerability end point to compare the cost-effectiveness, from the perspective of a U.S. health care payer, of almotriptan and sumatriptan in the treatment of an acute migraine attack. METHODS: The composite end point .Sustained pain free and No Adverse Events...

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Autores principales: Williams, Paul, Reeder, C. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438247/
https://www.ncbi.nlm.nih.gov/pubmed/15228377
http://dx.doi.org/10.18553/jmcp.2004.10.3.259
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author Williams, Paul
Reeder, C. E.
author_facet Williams, Paul
Reeder, C. E.
author_sort Williams, Paul
collection PubMed
description OBJECTIVES: To use a composite efficacy/tolerability end point to compare the cost-effectiveness, from the perspective of a U.S. health care payer, of almotriptan and sumatriptan in the treatment of an acute migraine attack. METHODS: The composite end point .Sustained pain free and No Adverse Events. (SNAE) was created from the sustained pain free and adverse event rates obtained in a meta-analysis of 53 placebo-controlled trials of oral triptans. The total direct cost of treating a single migraine attack was calculated from published sources. RESULTS: In the base-case analysis, the average cost-effectiveness ratios (CERs) were $82, $133, and $138 (per attack at which SNAE is achieved, 2004 prices) for almotriptan 12.5 mg, sumatriptan 50 mg, and sumatriptan 100 mg, respectively; the incremental CERs for almotriptan 12.5 mg were $12 and $16 (compared with sumatriptan 50 mg and sumatriptan 100 mg, respectively) per incremental attack at which SNAE is achieved. Sensitivity analyses were conducted to explore the impact of (1) relaxing the base-case assumptions (independence of efficacy and tolerability, uniform apportionment of health service use costs across attacks, number of tablets used to treat 1 attack); (2) varying input costs; and (3) uncertainty in the efficacy and tolerability estimates from the meta-analysis. In all of these sensitivity analyses, almotriptan 12.5 mg remained cost effective compared with sumatriptan 50 mg and 100 mg. CONCLUSIONS: Almotriptan was economically superior to sumatriptan in the treatment of a migraine attack.
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spelling pubmed-104382472023-08-21 A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point Williams, Paul Reeder, C. E. J Manag Care Pharm Formulary Management OBJECTIVES: To use a composite efficacy/tolerability end point to compare the cost-effectiveness, from the perspective of a U.S. health care payer, of almotriptan and sumatriptan in the treatment of an acute migraine attack. METHODS: The composite end point .Sustained pain free and No Adverse Events. (SNAE) was created from the sustained pain free and adverse event rates obtained in a meta-analysis of 53 placebo-controlled trials of oral triptans. The total direct cost of treating a single migraine attack was calculated from published sources. RESULTS: In the base-case analysis, the average cost-effectiveness ratios (CERs) were $82, $133, and $138 (per attack at which SNAE is achieved, 2004 prices) for almotriptan 12.5 mg, sumatriptan 50 mg, and sumatriptan 100 mg, respectively; the incremental CERs for almotriptan 12.5 mg were $12 and $16 (compared with sumatriptan 50 mg and sumatriptan 100 mg, respectively) per incremental attack at which SNAE is achieved. Sensitivity analyses were conducted to explore the impact of (1) relaxing the base-case assumptions (independence of efficacy and tolerability, uniform apportionment of health service use costs across attacks, number of tablets used to treat 1 attack); (2) varying input costs; and (3) uncertainty in the efficacy and tolerability estimates from the meta-analysis. In all of these sensitivity analyses, almotriptan 12.5 mg remained cost effective compared with sumatriptan 50 mg and 100 mg. CONCLUSIONS: Almotriptan was economically superior to sumatriptan in the treatment of a migraine attack. Academy of Managed Care Pharmacy 2004-05 /pmc/articles/PMC10438247/ /pubmed/15228377 http://dx.doi.org/10.18553/jmcp.2004.10.3.259 Text en Copyright © 2004, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Formulary Management
Williams, Paul
Reeder, C. E.
A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point
title A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point
title_full A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point
title_fullStr A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point
title_full_unstemmed A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point
title_short A Comparison of the Cost-Effectiveness of Almotriptan and Sumatriptan in the Treatment of Acute Migraine Using a Composite Efficacy/Tolerability End Point
title_sort comparison of the cost-effectiveness of almotriptan and sumatriptan in the treatment of acute migraine using a composite efficacy/tolerability end point
topic Formulary Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438247/
https://www.ncbi.nlm.nih.gov/pubmed/15228377
http://dx.doi.org/10.18553/jmcp.2004.10.3.259
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