Objectives: Migraine is a highly prevalent neurological disorder. The most characteristic symptom of migraine is moderate to severe recurrent headache along with other neurological symptoms. In this study, we modeled the potential reduction in migraine days and corresponding avoided productivity losses if erenumab was prescribed to the patient population indicated for prophylactic migraine treatment ($ 4 monthly migraine days [MMDs]) in Germany from 2020 to the end of 2027.Methods: We simulated the incremental benefits of erenumab against the standard of care. Response rates, transition probabilities, discontinuation rates, and productivity estimates were derived from the erenumab clinical trial program. Patients had a probability of residing in 1 of 7 states, given the MMDs in addition to the probability of death. Based on accrued MMDs in every cycle, days of absenteeism and presenteeism for paid and unpaid work were derived. Paid work was monetized according to gross value added using the human capital approach, whereas 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: Our results show that prescribing erenumab for the indicated population in Germany could lead to a reduction of 166 million migraine days annually and reduce productivity losses in the range of V27 billion. This includes V13.1 billion from direct productivity and V13.5 billion from economic value chain effects.Conclusions: This study highlights the macroeconomic effects of a systematic introduction of novel inhibitors of the calcitonin gene-related peptide pathway for migraine in Germany.

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ICER is 262,30 V/week on NEDA. Conclusions: Although more expensive in terms of drug acquisition costs, Interferon beta-1a 44mcg tiw results in a lower cost-effectiveness ratio in terms of cost per week achieved on NEDA, thus dominating by extension Interferon beta-1a 30mcg qw and being a better option if value for money is the main focus.