Bhambri Rahul, Mardekian Jack, Liu Larry Z, Schweizer Edward, Ramos Elodie
Pfizer, Inc., New York, NY, USA.
Pfizer, Inc., New York, NY, USA ; Weill Medical College of Cornell University, New York, NY, USA.
Int J Gen Med. 2015 Jan 12;8:27-36. doi: 10.2147/IJGM.S73673. eCollection 2015.
Migraine is a commonly occurring, chronic disorder that can cause significant disability. Eletriptan, a selective serotonin 5-hydroxytryptamine 1 receptor subtype B/D (5-HT1B/1D) agonist, is a clinically effective treatment for moderate to severe migraine. The objective of this literature review was to summarize the available data on the pharmacoeconomics of eletriptan relative to other triptans. Articles meeting the following three criteria were included in the review: 1) contained pharmacoeconomic data on a marketed dose of eletriptan; 2) included data on at least one other comparator triptan; and 3) was in English. A MEDLINE(®) search yielded a total of eight studies (from the European Union [n=5] and from the USA [n=3]) across multiple regions. Seven of the studies examined the pharmacoeconomics of eletriptan relative to other triptans, and a further study examined the health care costs of eletriptan 40 mg versus sumatriptan 100 mg. Eletriptan 40 mg was among a group of triptans, including rizatriptan 10 mg and almotriptan 12.5 mg, demonstrating the greatest cost-effectiveness. This result held across different definitions of efficacy (2 hours pain-free, sustained pain-free, and sustained pain-free with no adverse events) and also held when cost-effectiveness models accounted for second doses and use of rescue medication, management of adverse events, and productivity loss, in addition to drug acquisition costs. Only limited head-to-head comparator data were available. The majority of pharmacoeconomic studies utilized the same set of efficacy and/or tolerability data, and indirect costs were rarely included despite the fact that the majority of per capita migraine costs are attributable to indirect costs. In summary, although the market is now dominated by generics, eletriptan 40 mg is among the most clinically and cost-effective oral triptans available for the management of acute migraine. Increased effectiveness/efficacy of eletriptan may necessitate a lesser need for other migraine treatments and/or switching to other triptans.
偏头痛是一种常见的慢性疾病，会导致严重的功能障碍。依立曲坦是一种选择性5-羟色胺1B/D受体亚型（5-HT1B/1D）激动剂，是治疗中度至重度偏头痛的临床有效药物。这篇文献综述的目的是总结依立曲坦相对于其他曲坦类药物的药物经济学现有数据。符合以下三个标准的文章被纳入综述：1）包含依立曲坦上市剂量的药物经济学数据；2）包括至少一种其他对照曲坦类药物的数据；3）为英文。对MEDLINE(®)的检索在多个地区共获得八项研究（来自欧盟[n = 5]和美国[n = 3]）。其中七项研究考察了依立曲坦相对于其他曲坦类药物的药物经济学，另一项研究考察了40毫克依立曲坦与100毫克舒马曲坦的医疗保健成本。40毫克依立曲坦与包括10毫克利扎曲坦和12.5毫克阿莫曲坦在内的一组曲坦类药物一样，显示出最大的成本效益。这一结果在不同的疗效定义（2小时无痛、持续无痛、持续无痛且无不良事件）下均成立，并且在成本效益模型除了考虑药物采购成本外，还考虑了第二剂药物和急救药物的使用、不良事件的管理以及生产力损失时也成立。仅有有限的直接比较对照数据。大多数药物经济学研究使用了同一组疗效和/或耐受性数据，尽管人均偏头痛成本的大部分归因于间接成本，但间接成本很少被纳入。总之，尽管现在市场上仿制药占主导地位，但40毫克依立曲坦是可用于治疗急性偏头痛的临床和成本效益最高的口服曲坦类药物之一。依立曲坦有效性/疗效的提高可能会减少对其他偏头痛治疗的需求和/或转向其他曲坦类药物的必要性。
