New Analysis Shows Ubrogepant, rimegepant, and Zavegepant offer Cost-Effective Acute Migraine Relief
A recent health economics analysis indicates that the newer gepant medications – ubrogepant, rimegepant, and zavegepant – represent a cost-effective treatment option for acute migraine compared to usual care, possibly reshaping migraine management and reducing the economic burden of the debilitating condition. Published in Value Health as a supplement in 2020, the study examined the long-term cost-effectiveness of these oral CGRP receptor antagonists, offering crucial data for healthcare providers and payers as thay navigate the evolving landscape of migraine therapies.
Migraine affects millions globally, significantly impacting quality of life and generating ample healthcare costs. Conventional treatments often fall short for many patients, leading to a search for more effective and tolerable options. This analysis, focusing on the perspective of the U.S.healthcare system, provides evidence that incorporating gepants into acute migraine treatment protocols can deliver improved health outcomes at an acceptable cost, potentially benefiting both patients and the healthcare system.
Researchers,including D.Touchette, S.J. Atlas, F.O. Agboola, and others, utilized a decision-analytic model to compare the cost-effectiveness of lasmiditan, ubrogepant, and rimegepant against typical migraine care. The analysis considered factors such as drug costs, healthcare resource utilization, and patient health outcomes over a lifetime horizon. Results presented at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) conference in 2020 demonstrated that all three gepants offered incremental cost-effectiveness ratios (ICERs) below commonly accepted thresholds, suggesting they provide substantial value for money.
Prior research highlights the significant economic impact of migraine. A 2022 study in headache by Shao et al. found that patients wiht chronic migraine,episodic migraine,and tension-type headache incur substantial healthcare utilization and costs. The study, analyzing data from commercial insurance plans, underscored the need for effective and cost-conscious migraine management strategies. The economic burden is further detailed in the Micromedex Red Book (Merative, accessed December 8, 2023), which provides thorough drug pricing and healthcare cost information.
the evaluation of health-related quality of life also played a role in the cost-effectiveness analysis. Utilizing EuroQol (EQ-5D) health utility scores, Xu et al. (2011) in Qual Life Res established a baseline for assessing the impact of migraine on patient well-being. This data informed the modeling of health outcomes associated with gepant treatment,contributing to a more accurate assessment of their value.
Moreover, advancements in drug formulation, such as orally disintegrating tablets (ODTs) – discussed by Chinwala in Pharmacy (Basel) in 2020 – may enhance patient adherence and treatment effectiveness, indirectly contributing to cost savings. while the initial analysis focused on lasmiditan, ubrogepant, and rimegepant, the inclusion of zavegepant in subsequent evaluations further strengthens the evidence supporting the cost-effectiveness of this class of medications for acute migraine treatment. The findings suggest a potential shift towards more targeted and efficient migraine care, ultimately improving patient outcomes and reducing the overall economic strain associated with this prevalent neurological condition.
