Table 1.
Summary of the characteristics of included studies
| Authors (Year), Country | Objective(s) | Study design | Study population | Sub-groups | Sample size (n) | Intervention | Comparators | Type of Economic Evaluation |
|---|---|---|---|---|---|---|---|---|
| Journal Articles | ||||||||
| Batty AJ, et al. (2013), United Kingdom [16] | To evaluate the cost-effectiveness of Ona botulinumtoxin A (Botox) compared with placebo for the prophylaxis of headaches in adults with chronic migraine (CM) | Model based economic evaluation | Participants in The Phase III REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) Trial were considered for the model. | The groups comprised: 1) The licensed population, of all CM participants (n = 401), 2) Participants who have previously received one or more oral prophylactic treatments (only Topiramate was a licensed treatment for migraine) (n = 983), and 3) Participants who have previously received three or more oral prophylactic treatments (n = 439) | 1384 | Botox | Placebo | Cost-utility analysis (CUA) |
| Giannouchos TV, et al. (2019), Greece [17] | To evaluate the differences in costs and outcomes of the preventive treatment with Erenumab versus ONBTA in CM participants | Model based economic evaluation | Participants with CM who fail initial preventive treatment with ONBTA or Erenumab. Adults with a mean age 41 years; and 86% were females. | None | Not reported | Erenumab | Botox | CUA |
| Hansson-Hedblom A, et al. (2020), Norway and Sweden [18] | To describe the economic consequences of migraine in Sweden using cost of illness survey data and the cost-effectiveness of ONBTA for the treatment of CM | Model based economic evaluation | Participants in Phase III PREEMPT trial | As in other study using PREEMPT trial participants | Not reported | Botox | Placebo | CUA |
| Hollier-Hann G, et al. (2020), United Kingdom [19] | To evaluate the cost-effectiveness of Botox compared with placebo for the prophylaxis of headaches in adults with CM | Model based economic evaluation | Participants with CM who have previously received three or more oral preventive therapies in PREEMPT Trial | None | 439 | Botox | Placebo | CUA |
| Lipton RB, et al. (2018), United States of America [20] | To estimate value-based pricing ranges for Erenumab 140 mg, administered subcutaneously every 4 weeks, in participants who have failed at least 1 prior preventive treatment compared to supportive care (SC) | Model based economic evaluation | Participants that were either naïve to preventive treatment or previously treated with preventive medication but failed due to lack of efficacy or intolerability. The migraine populations considered in the model are sub-groups of participants who have previously failed “1 prior preventive therapy. | Chronic and episodic migraine (EM) group | Not reported | Erenumab | Placebo (vs Botox as a scenario analysis) | CUA |
| Mahon R, et al. (2021), Sweden [21] | To determine the cost-effectiveness of Erenumab for the preventive treatment of migraine. | Model based economic evaluation | Participants with CM and EM. The base-case analysis for ‘total migraine’ assumed that 66.7% of the participants had CM and 33.3% had EM, which aligns with the reported percentage of participants with CM for whom prophylactic treatment fails. | None | Not reported | Erenumab | Placebo (vs Botox as a scenario analysis) | CUA |
| Ruggeri et al. (2013), Italy [22] | To evaluate the cost-effectiveness of Botox versus placebo in participants with CM | Model based economic evaluation | Participants with CM from PREEMPT trial. | None | 1384 participants. 686 received treatment and 698 received placebo | Botox | Placebo | CUA |
| Sussman M, et al. (2018), United States of America [23] | To assess the cost-effectiveness of Erenumab for the prophylactic treatment of EM and CM | Model based economic evaluation | Participant with EM and CM. The analyses were done separately | CM and EM groups | Not stated | Erenumab | Placebo (vs Botox as a scenario analysis) | CUA |
| Vekov (2019), Bulgaria [24] | To develop a model based on local data on costs and health benefits of alternative Calcitonin gene-related peptide (CGRP) inhibitors in Bulgaria | Model based economic evaluation | Participants with EM and CM | CM and EM groups. For the CM group only participants who have not improved with standard preventive therapy were included | 667 | Erenumab | Preventative treatment | CUA |
| Other Reports | ||||||||
| CADTH (Botox) (2019), Canada [25] | To compare cost-effectiveness of Botox with existing treatments | Canada | Model based economic evaluation | Participants with CM from PREEMPT trial. | 1384 | Botox | Best supportive care (BSC) | CUA |
| CADTH (Erenumab) (2019), Canada [26] | To compare cost-effectiveness of Erenumab with existing treatments | Canada | Model based economic evaluation | Adult participants with CM, defined as headache 15 or more days per month and headache lasting four hours a day or longer (Study 295, STRIVE trial and LIBERTY trial) | Not stated | Erenumab | BSC, (vs Botox in scenario analysis) | CUA |
| ICER (2018), United States of America [27] | To compare cost-effectiveness of Calcitonin Gene- Related Peptide (CGRP) inhibitors as the preventative treatments for participants with EM or CM | USA | Model based economic evaluation | Patients with CM who fail initial preventive treatment with Botox or other treatment for the prevention of migraine attack | Not stated | Erenumab, Fremanezumab | BSC | CUA |
| NICE: Erenumab (2019), United Kingdom [29] | To compare cost-effectiveness of Erenumab with existing treatments | UK | Model based economic evaluation | Patients with CM who fail initial preventive treatment with Botox or other treatment for the prevention of migraine attack. | 439 | Erenumab | BSC and Botox | CUA |
| NICE: Fremanezumab (2019), United Kingdom [28] | To compare cost-effectiveness of Fremanezumab with existing treatments | UK | Model based economic evaluation | Patients with CM who fail initial preventive treatment with Botox or other treatment for the prevention of migraine attack. | 439 | Fremanezumab | BSC and Botox | CUA |
| NICE: Galcenzenumab (2020), United Kingdom [30] | To compare cost-effectiveness of Glacanzunab with existing treatments | UK | Model based economic evaluation | Patients with CM who fail initial preventive treatment with Botox or other treatment for the prevention of migraine attack. | 439 | Glacanzunab | BSC and Botox | CUA |
| Warwick Evidence (2011), United Kingdom [31] | To compare cost-effectiveness of Botox with existing treatments | UK | Model based economic evaluation | Patients in The Phase III REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) Trial were considered for the model. | 1384 | Botox | Placebo | CUA |
CGRP Calcitonin gene-related peptide, CM Chronic migraine, CUA Cost utility analysis, EM Episodic migraine, ONBTA Ona botulinumtoxin A, PREEMPT Patients in The Phase III REsearch Evaluating Migraine Prophylaxis Therapy, SC Supportive care