The Role of Productivity Measures in Economic Evaluations of Migraine Therapies
Author(s)
Amy Wu, PharmD, Paige Ngo, PharmD, Dan Gratie, PharmD, MS, Lorie Mody, PharmD, Richard H. Stanford, PharmD, MS;
AESARA, Chapel Hill, NC, USA
AESARA, Chapel Hill, NC, USA
Presentation Documents
OBJECTIVES: To examine economic evaluations for migraine therapies that incorporate productivity measures, explore the methodologies used to quantify productivity losses and gains, and describe overall impact of including these measures on incremental cost-effective ratios (ICERs).
METHODS: A search of Embase was conducted from January 1, 2014, to September 30, 2024, to identify economic evaluations such as cost-effectiveness analyses (CEAs), cost-utility analyses (CUAs), and cost-benefit analyses (CBAs) that incorporated productivity as a measure. Data were extracted on model perspective, methods used to calculate productivity, and the impact of productivity measures on ICERs.
RESULTS: The literature search identified a total of 1778 studies. Fifteen studies were included which were comprised of CUAs (n=12), CBA (n=2), and CEA (n=1). Eleven studies used a societal perspective when assessing costs. The majority of interventions assessed (n=13) were calcitonin gene-related peptide antagonists, with supportive care as comparator in most cases (n=11). Productivity losses were measured using general tools like the Work Productivity and Activity Impairment (WPAI, n=3) questionnaire or migraine-specific tools such as the Migraine Disability Assessment Survey (MIDAS, n=8). Indirect costs were calculated using the human capital approach (n=9) or the friction cost method (n=1). Three studies showed that changing from a healthcare system or payer perspective to societal, which incorporates indirect costs, resulted in a lower ICER. Three studies showed higher ICERs when productivity losses were excluded within scenario analyses. Additionally, 3 studies identified the number of days lost due to impaired productivity as a top-3 sensitivity analysis factor; 2 others noted lost productivity time as a sensitivity factor but not among the top 3.
CONCLUSIONS: This literature review highlights that productivity-related factors may influence economic evaluation outcomes in migraine where there is a large contribution of indirect costs. The findings emphasize the need for further research to understand how incorporating productivity measures impacts healthcare decision-making in migraine.
METHODS: A search of Embase was conducted from January 1, 2014, to September 30, 2024, to identify economic evaluations such as cost-effectiveness analyses (CEAs), cost-utility analyses (CUAs), and cost-benefit analyses (CBAs) that incorporated productivity as a measure. Data were extracted on model perspective, methods used to calculate productivity, and the impact of productivity measures on ICERs.
RESULTS: The literature search identified a total of 1778 studies. Fifteen studies were included which were comprised of CUAs (n=12), CBA (n=2), and CEA (n=1). Eleven studies used a societal perspective when assessing costs. The majority of interventions assessed (n=13) were calcitonin gene-related peptide antagonists, with supportive care as comparator in most cases (n=11). Productivity losses were measured using general tools like the Work Productivity and Activity Impairment (WPAI, n=3) questionnaire or migraine-specific tools such as the Migraine Disability Assessment Survey (MIDAS, n=8). Indirect costs were calculated using the human capital approach (n=9) or the friction cost method (n=1). Three studies showed that changing from a healthcare system or payer perspective to societal, which incorporates indirect costs, resulted in a lower ICER. Three studies showed higher ICERs when productivity losses were excluded within scenario analyses. Additionally, 3 studies identified the number of days lost due to impaired productivity as a top-3 sensitivity analysis factor; 2 others noted lost productivity time as a sensitivity factor but not among the top 3.
CONCLUSIONS: This literature review highlights that productivity-related factors may influence economic evaluation outcomes in migraine where there is a large contribution of indirect costs. The findings emphasize the need for further research to understand how incorporating productivity measures impacts healthcare decision-making in migraine.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE7
Topic
Economic Evaluation
Disease
SDC: Neurological Disorders