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Cost‐Effectiveness of Antiepileptic Drugs in Migraine Prophylaxis
Author(s) -
Adelman James U.,
Adelman Leon C.,
Von Seggern Randal
Publication year - 2002
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1046/j.1526-4610.2002.02227.x
Subject(s) - topiramate , migraine , medicine , gabapentin , headaches , divalproex , clinical trial , placebo , epilepsy , cost effectiveness , anesthesia , psychiatry , lithium (medication) , bipolar disorder , alternative medicine , mania , risk analysis (engineering) , pathology
Objective.—To analyze the cost‐effectiveness of antiepileptics in migraine prophylaxis. Methods.—A cost‐effectiveness analysis was performed using efficacy data from three recent, double‐blind, placebo‐controlled, clinical trials of antiepileptic drugs studied for migraine prevention and cost data. Two measures of cost‐effectiveness were used: cost per headache prevented and the cost‐equivalent number. Results.—In the double‐blind, placebo‐controlled, clinical trials evaluated, three antiepileptic drugs were shown to be effective in migraine prevention. All three antiepileptic drugs had high costs per migraine reduced. Gabapentin was the most costly at $138.00 per migraine prevented, whereas the cost per migraine prevented with topiramate was $114.80 and with divalproex sodium was $48.00. For migraine prevention divalproex sodium became cost‐effective with 10 migraines per month, whereas gabapentin and topiramate required considerably more migraines per month to be cost‐effective. Conclusions.—Antiepileptic drugs have proven effectiveness in migraine prophylaxis. However, in patients responsive to their acute care medications, the antiepileptic drugs are only cost‐effective for those patients with a high frequency of migraines and those with comorbid diseases. Future studies should be done with antiepileptic drugs in patients exhibiting a migraine frequency of 10 or more headaches per month.