偏头痛预防的成本效益：托吡酯在英国的情况。

Cost-effectiveness of migraine prevention: the case of topiramate in the UK.

作者信息

Brown J S, Papadopoulos G, Neumann P J, Price M, Friedman M, Menzin J

机构信息

Harvard Medical School/Harvard Pilgrim Health Care, Department of Ambulatory Care & Prevention, Boston, MA, USA.

出版信息

Cephalalgia. 2006 Dec;26(12):1473-82. doi: 10.1111/j.1468-2982.2006.01240.x.

DOI:10.1111/j.1468-2982.2006.01240.x

PMID:17116098

Abstract

The aim of this study was to assess the cost-effectiveness of topiramate vs. no preventive treatment in the UK. Model inputs included baseline migraine frequency, treatment discontinuation and response, preventive and acute medical cost per attack [2005 GBP ( pound)] and gain in health utility. Outcomes included monthly migraines averted, acute and preventive treatment costs and cost per quality-adjusted life year (QALY). Topiramate was associated with 1.8 fewer monthly migraines and a QALY gain of 0.0384. The incremental cost of topiramate vs. no preventive treatment was about 10 UK pounds per migraine averted and 5700 UK pounds per QALY. Results are sensitive to baseline monthly migraine frequency, triptan use rate and the gain in utility. Incorporating savings from reduced work loss (about 36 UK pounds per month) suggests that topiramate would be cost saving compared with no preventive treatment. This analysis suggests that topiramate is a cost-effective treatment for migraine prevention compared with no preventive treatment.

摘要

本研究的目的是评估在英国托吡酯与不进行预防性治疗相比的成本效益。模型输入包括基线偏头痛发作频率、治疗中断和反应、每次发作的预防性和急性医疗费用[2005年英镑]以及健康效用增益。结果包括每月避免的偏头痛发作次数、急性和预防性治疗费用以及每质量调整生命年（QALY）的成本。托吡酯与每月偏头痛发作次数减少1.8次以及QALY增益0.0384相关。与不进行预防性治疗相比，托吡酯的增量成本约为每避免一次偏头痛发作10英镑，每QALY为5700英镑。结果对基线每月偏头痛发作频率、曲坦类药物使用率和效用增益敏感。纳入因工作损失减少而节省的费用（约每月36英镑）表明，与不进行预防性治疗相比，托吡酯可节省成本。该分析表明，与不进行预防性治疗相比，托吡酯是一种具有成本效益的偏头痛预防治疗方法。