UNASSIGNED: A de novo model was developed to estimate incremental costs and quality-adjusted life years (QALYs), structured as a decision tree followed by Markov model. Patients received rimegepant or BSC for a migraine attack and were assessed for response (pain relief at 2-h). Responders and non-responders followed different pain trajectories over 48-h cycles. Non-responders discontinued treatment while responders continued treatment for subsequent attacks, with a proportion discontinuing over time. Data sources included a post-hoc pooled analysis of the phase 3 acute rimegepant trials (NCT03235479, NCT03237845, NCT03461757), and a long-term safety study (NCT03266588). The analysis was conducted from the perspective of the UK National Health Service and Personal Social Services over a 20-year time horizon.
UNASSIGNED: Rimegepant resulted in an incremental cost-utility ratio (ICUR) of £10,309 per QALY gained vs BSC, which is cost-effectiveness at a willingness to pay threshold of £30,000/QALY. Rimegepant generated +0.44 incremental QALYs and higher incremental lifetime costs (£4,492). Improved QALYs for rimegepant were a result of less time spent with severe and moderate headache pain.
UNASSIGNED: This study highlights the economic value of rimegepant which was found to be cost-effective for the acute treatment of migraine in adults unsuitable for triptans.
■开发了一个从头模型来估计增量成本和质量调整寿命年(QALYs),构造为决策树,后跟马尔可夫模型。患者接受了偏头痛发作的Rimegepant或BSC,并评估了反应(2小时后疼痛缓解)。响应者和非响应者在48小时周期内遵循不同的疼痛轨迹。无应答者停止治疗,而应答者继续治疗随后的攻击,随着时间的推移,有一部分会中断。数据来源包括对3期急性Rimegepant试验的事后汇总分析(NCT03235479,NCT03237845,NCT03461757),和长期安全性研究(NCT03266588)。该分析是在20年的时间范围内从英国国家卫生服务和个人社会服务的角度进行的。
■Rimegepant导致每QALY相对于BSC的增量成本效用比(ICUR)为10,309英镑,这是愿意支付30,000英镑/QALY门槛的成本效益。Rimegepant产生了+0.44个增量QALY和更高的增量生命周期成本(4,492英镑)。改善Rimegepant的QALY是由于减少了严重和中度头痛的时间。
■这项研究强调了rimegepant的经济价值,发现rimegepant对于不适合曲坦的成人偏头痛的急性治疗具有成本效益。