OBJECTIVES:

Migraine is a common neurological disease associated with substantial humanistic and economic burden. There is high unmet need in patients who have failed previous preventives. This analysis quantifies the clinical burden in episodic (EM) and chronic (CM) migraine patients who have failed ≥1 prior preventive, and models the treatment effect of erenumab, a monoclonal antibody binding calcitonin gene-related peptide (CGRP) receptors.

METHODS:

An economic model was developed to predict the mean number of monthly migraine days (MMD) experienced by EM and CM patients who have failed ≥1 prior preventive, currently treated with acute medication only. The outcomes of previously-treated patients on erenumab were estimated based on changes from baseline in MMD observed in the erenumab 140mg groups of two pivotal clinical studies (NCT02456740 and NCT02066415). The statistical approach adopted allows modeling of the change from baseline over time in MMD and the distribution of individual patients by MMD. The predicted number of MMD were aggregated over one year of continuous erenumab treatment and compared to patients on no prevention, to estimate average migraine days (MD) per year. Patients on no prevention were assumed to remain at their baseline MMD.

RESULTS:

Patients treated only with acute medication were predicted to suffer averages of 112.5 MD in EM and 239.5 MD in CM, over one year. Treated with erenumab, patients were predicted to avoid 39.8 MD and 87.8 MD in EM and CM, respectively, over one continuous year of treatment.

CONCLUSIONS:

The clinical burden of migraine to individual patients is high, and can be substantially reduced by treatment with erenumab. These MMD are associated with substantial costs of medical resource use, acute medication use and lost productivity, as well as impacts on patient functioning and quality of life. These outcomes should be considered when conducting economic evaluations of migraine preventives.