OBJECTIVES: To evaluate societal and economic benefits of self-administrated injection of sumatriptan succinate compared to hospital-administrated one in the treatment of acute severe migraine in Japan setting. METHODS:  A cost-utility analysis (cost per QALY gained) by simulating with a 5-state Markov Model is conducted from the societal perspective. Parameters incorporated into the model were taken from literatures and the PMS of subcutaneous sumatriptan carried out in Japan. Cost components incorporated into the model consist of migraine-related medical costs, medicines, and transportation costs for traditional health care provider and emergency room visits, calculating with Japan insurance-based medical fee scheme for medical techniques and national health insurance price of medicines. To assess robustness of a base case, univariate sensitivity analyses using tornado diagram and probabilistic analysis using 10000-time Monte Carlo simulation were performed. TreeAge Pro 2007 was used for the data analysis. RESULTS: At the base case, it was deemed that use of self-administrated injection was less costly and more effectiveness than hospital-administrated one. Univariate analyses revealed that probability of onset of attack per week was identified as a cost driver. The probabilistic analysis suggested that if willingness to pay on decision-making in Japan setting was set at 5,000,000 JPY per QALY gained, approximately 100% of probability were obtained dominant consequences in a hypothetical cohort. Therefore, it was demonstrated robustness of the base case analysis, retrospectively. CONCLUSIONS: Thus, the aforementioned result suggested that the use of self-administrated injection dominated hospital-administrated one irrespective of a high initial price of self-administrated injection.