Real-world evidence on the economic implications of CGRP-mAbs as preventive treatment of migraine

Research output: Contribution to journalJournal articleResearchpeer-review

Documents

  • Fulltext

    Final published version, 1.17 MB, PDF document

  • Nikolaj Siersbæk
  • Lærke Kilsdal
  • Christian Jervelund
  • Sonja Antic
  • Bendtsen, Lars

Background: Calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) are approved in Europe as preventive treatment of migraine in patients with at least four monthly migraine days. Migraine gives rise to direct healthcare expenditures, but most of the economic burden of migraine is socioeconomic. Evidence on the socioeconomic implications of CGRP-mAbs is, however, limited. There is an increasing interest in supplementing evidence from randomised controlled trials (RCTs) with real-world evidence (RWE) to aid clinical decision making and inform decision making for migraine management. The objective of this study was to generate RWE on the health economic and socioeconomic implications of administering CGRP-mAbs to patients with chronic migraine (CM) and episodic migraine (high-frequency episodic migraine (HFEM), and low-frequency episodic migraine (LFEM)). Methods: Real-world data (RWD) on Danish patients with CM, HFEM, and LFEM were collected via two Danish patient organisations and two informal patient networks and used in a tailored economic model. Treatment effects of CGRP-mAbs on health economic and socioeconomic outcomes were estimated using a sub-sample of patients with CM who receive CGRP-mAb treatment. Results: A total of 362 patients (CM: 199 [55.0%], HFEM: 80 [22.1%], LFEM: 83 [22.9%]) were included in the health economic model (mean age 44.1 ± 11.5, 97.5% female, 16.3% received treatment with CGRP-mAbs), and 303 patients were included in the socioeconomic model (15.2% received treatment with CGRP-mAbs). Health economic savings from initiating CGRP-mAb treatment totalled €1,179 per patient with CM per year on average (HFEM: €264, LFEM: €175). Socioeconomic gains from initiating CGRP-mAb treatment totalled an average gross domestic product (GDP) gain of €13,329 per patient with CM per year (HFEM: €10,449, LFEM: €9,947). Conclusion: Our results indicate that CGRP-mAbs have the potential to reduce both health economic expenditures and the socioeconomic burden of migraine. Health economic savings are used as a basis for health technology assessments (HTAs) of the cost-effectiveness of new treatments, which implies that important socioeconomic gains may not be given enough importance in decision making for migraine management.

Original languageEnglish
Article number254
JournalBMC Neurology
Volume23
Issue number1
Number of pages11
ISSN1471-2377
DOIs
Publication statusPublished - 2023

Bibliographical note

Funding Information:
The authors, NS, LK, and CJ disclosed receipt of the following financial support for the research, authorship, and publication of this article: This work was supported by Novartis Healthcare Denmark A/S (POP3 number DK2201120023).

Funding Information:
We thank all patients who participated in the study and the Migraine and Headache Association, Migraine Denmark, and two informal patient groups for their help recruiting participants. We thank Professor Jes Olesen and Professor Rigmor Højlund Jensen for their input in Copenhagen Economics’ preparations for the study. We also thank participants at the Migraine Trust International Symposium (MTIS) 2022 in London and the Migraine Summit 2022 in Copenhagen for useful comments. In addition, we thank MTIS 2022 for the opportunity to present an abstract on our findings and Cephalalgia for the publication of our abstract (identifier MTIS2022-152).

Funding Information:
Lars Bendtsen (LB) and Sonja Antic (SA) have both served on the scientific advisory board for Novartis, AbbVie (Allergan), Teva, Lundbeck, and Eli Lilly. The work of Nikolaj Siersbæk (NS), Lærke Kilsdal (LK), and Christian Jervelund (CJ) was funded my Novartis (POP3 number DK2201120023). CJ is a Partner of Copenhagen Economics, who received funding from Novartis. Novartis was involved in the study’s initiation and decision to submit it for publication, but neither Novartis and the other companies cited above nor anyone other than the authors had any involvement in the study’s design, data collection, analysis and interpretation, or writing of the manuscript.

Publisher Copyright:
© 2023, The Author(s).

    Research areas

  • CGRP-mAbs, Direct cost, Health economic savings, Indirect cost, Real-world evidence, Socioeconomic gains

ID: 372805100