Cost of fremanezumab, erenumab, galcanezumab and onabotulinumtoxinA associated adverse events, for migraine prophylaxis in Spain

ABSTRACT

Objective: To compare the cost of adverse events (AEs) associated with preventive treatment of migraine with fremanezumab, versus erenumab, galcanezumab, and onabotulinumtoxinA.

Methods: A probabilistic modeling analysis was performed, using second-order Monte Carlo simulations, with 1,000 simulations, in patients with at least 4 days of migraine per month, from the perspective of the National Health System and a time horizon of 12 weeks. The frequency of AEs described in the clinical trials was analyzed with 12 weeks of treatment. Unit costs (€) of management of AEs were obtained from public health prices, expert panels, and published Spanish studies.

Results: Fremanezumab would generate average savings of -€469 (95% CI -€303; -€674) versus erenumab, -€268 (95% CI -€171; -€391) versus galcanezumab, -€1,100 (95% CI -€704; -€1,608) or -€1,295 (95% CI -€835; -€1,893) versus onabotulinumtoxinA using real-life or clinical trial data, respectively.

Conclusions: The different safety profile of treatment with fremanezumab, compared to erenumab, galcanezumab, and onabotulinumtoxinA, would generate savings in health-care resources in all the scenarios considered.

KEYWORDS:

• Fremanezumab
• erenumab
• galcanezumab
• onabotulinumtoxinA
• adverse effects
• cost
• migraine disorders

Article highlights

• A probabilistic modeling analysis was performed, using second-order Monte Carlo simulations, with 1,000 simulations, in patients with at least 4 days of migraine per month, from the perspective of the National Health System and a time horizon of 12 weeks.

• The different safety profile of treatment with fremanezumab, compared to erenumab, galcanezumab, and onabotulinumtoxinA, would result in savings per patient of -€469, -€268 and -€1,100 or -€1,296, respectively.

• Savings from this concept were found in 100% of the simulations.

Declaration of interest

Carlos Rubio-Terrés and Darío Rubio-Rodríguez received fees from Teva Pharma Spain, regarding the present manuscript. Pablo Irimia has received honoraria from Allergan, Lilly, Novartis and Teva Pharmaceuticals as a consultant and speaker. Sonia Santos-Lasaosa has received honoraria from Allergan, Lilly, Novartis and Teva Pharmaceuticals as a consultant and speaker. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

A reviewer on this manuscript has disclosed being a speaker for Ubrelvy, but not related to my scientific analysis of this article. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

Study conducted with an aid to research, without restrictions, from Teva Pharma Spain.