Cost-effectiveness of Fremanezumab from a Societal Perspective in England
Author(s)
Skroumpelos A1, Freddi M2, Akcicek H1, Cohen J3, Driessen MT1
1Teva Pharmaceuticals, Amsterdam, Netherlands, 2Strategen, Winchester, UK, 3Teva Branded Pharmaceutical Products R&D, Inc., West Chester, PA, USA
OBJECTIVES: Migraine affects many people of working age during their most productive years. This disease can therefore have a substantial societal burden, which is not included within health technology assessments (HTAs) such as those conducted by NICE. The societal perspective within this study will capture the broader impacts of migraine and the potential related cost-effectiveness benefits from the migraine preventive therapy fremanezumab. METHODS: A semi-Markov cost-economic model that distributed patients across monthly migraine day (MMD) states (0-28 MMDs) was populated with efficacy and patient baseline data from the FOCUS clinical trial (NCT03308968) for those who had failed ≥3 previous preventive treatments. The following main assumptions were consistent with the reported NICE base case analysis and included: 10-year time horizon and discounting at 3.5%. Best supportive care (acute migraine treatment only, using FOCUS placebo efficacy) was a comparator for chronic migraine (CM) and episodic migraine (EM); onabotulinumtoxinA was a comparator for CM (its licensed indication; efficacy data derived from network meta-analysis). Data on work productivity losses (absenteeism and presenteeism) taken from published source (Lipton et al. J Med Econ 2018;21:666–675) with costs valued using average salary data from UK Office of National Statistics. RESULTS: For EM, fremanezumab has an incremental cost-effectiveness ratio (ICER) values of £4,527/quality-adjusted life-year (QALY) versus best supportive care (BSC) with the inclusion of indirect costs; compared to £14,408/QALY without consideration of these costs. In CM, with indirect costs fremanezumab is dominant over BSC (more QALYs and lower costs) and has an ICER of £446/QALY versus onabotulinumtoxinA. This compares to £11,880/QALY versus BSC and £16,716/QALY versus onabotulinumtoxinA without indirect costs. CONCLUSIONS: Fremanezumab is cost-effective under a healthcare perspective (as used in many HTAs across Europe). When a societal impact of migraine is considered, the cost-effectiveness of fremanezumab can be even more clearly demonstrated, especially in CM.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PND23
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Biologics and Biosimilars, Neurological Disorders