Table 5.
Health effects, costs and cost effectiveness of migraine management strategies in China, India, Russian Federation and Zambia
| China | India | Russian Federation | Zambia | ||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Target coverage* | Healthy life years gained per year (per 1 m popn) | Cost per year per capita (US$) | Cost per healthy life year gained (US$) | ICER (US$) | Healthy life years gained per year (per 1 m popn) | Cost per year per capita (US$) | Cost per healthy life year gained (US$) | ICER (US$) | Healthy life years gained per year (per 1 m popn) | Cost per year per capita (US$) | Cost per healthy life year gained (US$) | ICER (US$) | Healthy life years gained per year (per 1 m popn) | Cost per year per capita (US$) | Cost per healthy life year gained (US$) | ICER (US$) | |||||||||||||
| A. ACUTE MANAGEMENT (NON-SPECIFIC DRUGS) | |||||||||||||||||||||||||||||
| Simple analgesics (e.g. ASA 1 g) | 90% | 530 | $ | 0.02 | $ | 34 | $ | 35 | 673 | $ | 0.05 | $ | 73 | $ | 75 | 1223 | $ | 0.07 | $ | 53 | $ | 63 | 1244 | $ | 0.03 | $ | 24 | $ | 24 |
| With consumer education | 597 | $ | 0.03 | $ | 53 | $ | 204 | 757 | $ | 0.06 | $ | 77 | $ | 105 | 1376 | $ | 0.19 | $ | 136 | $ | 801 | 1400 | $ | 0.12 | $ | 85 | $ | 575 | |
| B. ACUTE MANAGEMENT (SPECIFIC DRUGS) | |||||||||||||||||||||||||||||
| Sumatriptan (50 mg) | 90% | 152 | $ | 2.14 | $ | 14,061 | 193 | $ | 1.20 | $ | 6,201 | 352 | $ | 12.55 | $ | 35,684 | 358 | $ | 2.62 | $ | 7,330 | ||||||||
| With consumer education | 212 | $ | 2.16 | $ | 10,159 | 269 | $ | 1.21 | $ | 4,485 | 490 | $ | 12.67 | $ | 25,869 | 498 | $ | 2.71 | $ | 5,442 | |||||||||
| With provider training | 178 | $ | 2.16 | $ | 12,129 | 226 | $ | 1.20 | $ | 5,335 | 410 | $ | 12.64 | $ | 30,804 | 417 | $ | 2.64 | $ | 6,329 | |||||||||
| With consumer education and provider training | 248 | $ | 2.17 | $ | 8,762 | 314 | $ | 1.21 | $ | 3,859 | 571 | $ | 12.76 | $ | 22,330 | 581 | $ | 2.73 | $ | 4,698 | |||||||||
| Almotriptan (12.5 mg) | 90% | 196 | $ | 5.59 | $ | 28,546 | 249 | $ | 14.55 | $ | 58,533 | 452 | $ | 23.38 | $ | 51,728 | 460 | $ | 8.82 | $ | 19,187 | ||||||||
| With consumer education | 273 | $ | 5.61 | $ | 20,544 | 346 | $ | 14.56 | $ | 42,049 | 630 | $ | 23.51 | $ | 37,332 | 640 | $ | 8.91 | $ | 13,915 | |||||||||
| With provider training | 229 | $ | 5.61 | $ | 24,528 | 290 | $ | 14.56 | $ | 50,187 | 527 | $ | 23.47 | $ | 44,508 | 536 | $ | 8.84 | $ | 16,482 | |||||||||
| With consumer education and provider training | 318 | $ | 5.62 | $ | 17,652 | 404 | $ | 14.56 | $ | 36,053 | 735 | $ | 23.60 | $ | 32,121 | 747 | $ | 8.93 | $ | 11,953 | |||||||||
| C. ACUTE STEPPED CARE MANAGEMENT | |||||||||||||||||||||||||||||
| ASA (1 g) + sumatriptan (50 mg) | 90% | 431 | $ | 2.52 | $ | 5,840 | 547 | $ | 1.62 | $ | 2,964 | 994 | $ | 15.71 | $ | 15,811 | 1011 | $ | 2.95 | $ | 2,917 | ||||||||
| With consumer education | 600 | $ | 2.53 | $ | 4,215 | 761 | $ | 1.63 | $ | 2,139 | 1384 | $ | 15.84 | $ | 11,440 | 1408 | $ | 3.04 | $ | 2,158 | |||||||||
| With provider training | 503 | $ | 2.53 | $ | 5,033 | 638 | $ | 1.62 | $ | 2,548 | 1160 | $ | 15.80 | $ | 13,630 | 1179 | $ | 2.97 | $ | 2,517 | |||||||||
| With consumer education and provider training | 700 | $ | 2.54 | $ | 3,633 | $ | 24,271 | 888 | $ | 1.63 | $ | 1,839 | $ | 11,996 | 1615 | $ | 15.93 | $ | 9,861 | $ | 65,920 | 1643 | $ | 3.06 | $ | 1,861 | $ | 12,102 | |
| D. PROPHYLAXIS + ACUTE MANAGEMENT | |||||||||||||||||||||||||||||
| ASA (1 g) + amitriptyline (100 mg) | 30% | 112 | $ | 0.18 | $ | 1,649 | 145 | $ | 0.26 | $ | 1,795 | 275 | $ | 1.45 | $ | 5,264 | 305 | $ | 0.24 | $ | 773 | ||||||||
| With consumer education | 189 | $ | 0.20 | $ | 1,047 | 245 | $ | 0.27 | $ | 1,098 | 465 | $ | 1.57 | $ | 3,377 | 515 | $ | 0.32 | $ | 631 | |||||||||
| With provider training | 130 | $ | 0.20 | $ | 1,517 | 169 | $ | 0.26 | $ | 1,565 | 321 | $ | 1.54 | $ | 4,790 | 355 | $ | 0.25 | $ | 716 | |||||||||
| With consumer education and provider training | 220 | $ | 0.21 | $ | 959 | 286 | $ | 0.27 | $ | 957 | 543 | $ | 1.66 | $ | 3,059 | 601 | $ | 0.34 | $ | 573 | |||||||||
| Sumatriptan (50 mg) + amitriptyline (100 mg) | 30% | 49 | $ | 0.73 | $ | 14,872 | 63 | $ | 0.53 | $ | 8,329 | 121 | $ | 3.95 | $ | 32,633 | 134 | $ | 1.09 | $ | 8,102 | ||||||||
| With consumer education | 83 | $ | 0.74 | $ | 8,962 | 107 | $ | 0.54 | $ | 5,010 | 205 | $ | 4.07 | $ | 19,902 | 227 | $ | 1.18 | $ | 5,188 | |||||||||
| With provider training | 68 | $ | 0.74 | $ | 10,908 | 88 | $ | 0.53 | $ | 6,049 | 168 | $ | 4.04 | $ | 24,027 | 186 | $ | 1.11 | $ | 5,937 | |||||||||
| With consumer education and provider training | 115 | $ | 0.76 | $ | 6,571 | 149 | $ | 0.54 | $ | 3,637 | 284 | $ | 4.16 | $ | 14,644 | 315 | $ | 1.19 | $ | 3,796 | |||||||||
| ASA + sumatriptan + amitriptyline | 30% | 103 | $ | 0.80 | $ | 7,740 | 133 | $ | 0.73 | $ | 5,467 | 248 | $ | 4.55 | $ | 18,319 | 275 | $ | 1.20 | $ | 4,362 | ||||||||
| With consumer education | 174 | $ | 0.81 | $ | 4,657 | 226 | $ | 0.74 | $ | 3,273 | 420 | $ | 4.67 | $ | 11,128 | 465 | $ | 1.29 | $ | 2,773 | |||||||||
| With provider training | 143 | $ | 0.81 | $ | 5,668 | 185 | $ | 0.73 | $ | 3,961 | 345 | $ | 4.64 | $ | 13,449 | 382 | $ | 1.22 | $ | 3,191 | |||||||||
| With consumer education and provider training | 241 | $ | 0.82 | $ | 3,409 | 313 | $ | 0.74 | $ | 2,371 | 583 | $ | 4.76 | $ | 8,166 | 645 | $ | 1.31 | $ | 2,026 | |||||||||
*Target coverage for acute management in Zambia set at 80%.
ICER=Incremental cost-effectiveness ratio. All interventions without an ICER value are 'dominated’.