Tian Shuo, Yang Yuping, Tan Shenglan, Luo Jiani, Yang Chuanyu, Liu Qiao, Guo Yujin
Department of Clinical Pharmacy, Jining First People's Hospital, Shandong First Medical University, Jining, China.
Department of Pharmacy, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, China.
Front Neurol. 2024 Aug 23;15:1411576. doi: 10.3389/fneur.2024.1411576. eCollection 2024.
This study assesses the cost-effectiveness of rimegepant for the on-demand acute treatment of migraine in the Chinese population, focusing on headache relief within a 2 h timeframe. Utilizing data from Phase III clinical trials on rimegepant involving Asian populations, this analysis aims to provide essential insights for healthcare decision-making in the context of migraine management in China.
Employing a decision tree model, this research evaluates the cost-effectiveness of rimegepant over a concise 2 h period, exclusively considering its direct market price of 219.00 CNY per dose for on-demand, single-use treatment upon approval in China. This model is based on pain relief outcomes from a clinical trial, categorizing health outcomes by the achievement of pain freedom and alleviation from the most bothersome symptom within two hours post-administration.
The study unveils that rimegepant adds 0.0018 quality-adjusted life days (QALD) with an incremental cost-effectiveness ratio (ICER) of 122,166.07 CNY/QALD. Against a daily cost-effectiveness threshold derived from the 2023 GDP of China (734.45 CNY/day), rimegepant falls short of proving its cost-effectiveness. A significant price reduction to approximately 1.32 CNY per dose is required for rimegepant to be considered cost-effective within this framework. Furthermore, a series of sensitivity analyses were conducted to validate the robustness of these results.
While rimegepant shows clinical efficacy in providing rapid relief from migraine symptoms, its current pricing exceeds the threshold for cost-effectiveness in the Chinese healthcare setting. This study underscores the need for price adjustments to enhance the accessibility and economic viability of new migraine treatments.
本研究评估瑞美吉泮在中国人群中按需急性治疗偏头痛的成本效益,重点关注2小时内的头痛缓解情况。利用瑞美吉泮的III期临床试验中涉及亚洲人群的数据,该分析旨在为中国偏头痛管理背景下的医疗决策提供重要见解。
本研究采用决策树模型,在简洁的2小时内评估瑞美吉泮的成本效益,仅考虑其在中国获批后按需单次使用治疗的直接市场价格,即每剂219.00元人民币。该模型基于一项临床试验的疼痛缓解结果,根据给药后两小时内实现无痛以及最困扰症状缓解的情况对健康结果进行分类。
研究表明,瑞美吉泮增加了0.0018个质量调整生命天(QALD),增量成本效益比(ICER)为122,166.07元人民币/QALD。与根据2023年中国国内生产总值得出的每日成本效益阈值(734.45元人民币/天)相比,瑞美吉泮未能证明其成本效益。在该框架内,瑞美吉泮要被认为具有成本效益,需要大幅降价至每剂约1.32元人民币。此外,还进行了一系列敏感性分析以验证这些结果的稳健性。
虽然瑞美吉泮在快速缓解偏头痛症状方面显示出临床疗效,但其当前定价超过了中国医疗环境中的成本效益阈值。本研究强调需要进行价格调整,以提高新的偏头痛治疗方法的可及性和经济可行性。