OBJECTIVES

Migraine is a highly prevalent neurological disorder that can manifest in a host of different symptoms. The most characteristic symptom of migraine is the moderate to severe recurrent headaches. Erenumab, a human monoclonal antibody that blocks the calcitonin gene-related peptide (CGRP) receptor has shown preventive effects in randomized clinical trials by lowering the number of Monthly Migraine Days (MMDs). In this study, we model the health-related and macroeconomic societal effects if erenumab were prescribed to the indicated patient population in Germany until 2025.

METHODS

We simulated the incremental benefits of erenumab in twelve gender and age subgroups. Response rates, transition probabilities, discontinuation rates and productivity estimates were derived from the erenumab clinical trial program. Patients had a probability of residing in one of seven states given MMDs in addition to the probability of death. Inputs on the prevalence and incidence were derived from a Global Burden of Disease study. The initial patient distribution among health states was derived from the German Headache Consortium Study.

Based on accrued MMDs every 3 months, days of absenteeism and presenteeism were derived. Employment data and Time Use Surveys were used to identify the total amount of lost time to paid and unpaid work activities. Paid work was monetized according to gross value added (GVA) using the German system of national accounts, while unpaid work was valuated according to the proxy good method. In addition, downstream macroeconomic effects were captured using value-added multipliers. Direct medical costs were concomitantly calculated.

RESULTS

Preliminary results indicate that prescribing erenumab for the indicated population in Germany could lead to a reduction of 95 million MMDs annually and reduce losses in GDP in the range of € 8.5 billion.

CONCLUSIONS

This novel study highlights the macroeconomic effects of a systematic introduction of novel CGRP inhibitors for migraine in Germany.