A review of the pharmacoeconomics of eletriptan for the acute treatment of migraine

Abstract

Migraine is a commonly occurring, chronic disorder that can cause significant disability. Eletriptan, a selective serotonin 5-hydroxytryptamine 1 receptor subtype B/D (5-HT1B/1D) agonist, is a clinically effective treatment for moderate to severe migraine. The objective of this literature review was to summarize the available data on the pharmacoeconomics of eletriptan relative to other triptans. Articles meeting the following three criteria were included in the review: 1) contained pharmacoeconomic data on a marketed dose of eletriptan; 2) included data on at least one other comparator triptan; and 3) was in English. A MEDLINE® search yielded a total of eight studies (from the European Union [n=5] and from the USA [n=3]) across multiple regions. Seven of the studies examined the pharmacoeconomics of eletriptan relative to other triptans, and a further study examined the health care costs of eletriptan 40 mg versus sumatriptan 100 mg. Eletriptan 40 mg was among a group of triptans, including rizatriptan 10 mg and almotriptan 12.5 mg, demonstrating the greatest cost-effectiveness. This result held across different definitions of efficacy (2 hours pain-free, sustained pain-free, and sustained pain-free with no adverse events) and also held when cost-effectiveness models accounted for second doses and use of rescue medication, management of adverse events, and productivity loss, in addition to drug acquisition costs. Only limited head-to-head comparator data were available. The majority of pharmacoeconomic studies utilized the same set of efficacy and/or tolerability data, and indirect costs were rarely included despite the fact that the majority of per capita migraine costs are attributable to indirect costs. In summary, although the market is now dominated by generics, eletriptan 40 mg is among the most clinically and cost-effective oral triptans available for the management of acute migraine. Increased effectiveness/efficacy of eletriptan may necessitate a lesser need for other migraine treatments and/or switching to other triptans.

Migraine Care in the Era of COVID‐19: Clinical Pearls and Plea to Insurers

“…Further, given that nearly 1/5 of households in the United States reported a layoff or reduction in work hours related to coronavirus by March 14, 2020, 3 it is imperative that insurance providers minimize or eliminate copays for migraine medications. While it may seem unthinkable to ask insurers to pay additional money for these therapies as other health care costs increase, multiple pharmacoeconomic studies have demonstrated that coverage of expensive migraine medications is actually cost‐saving, as it decreases disability and reliance on hospital care 4‐6 …”

Eletriptan in the management of acute migraine: an update on the evidence for efficacy, safety, and consistent response

“…In a recent multiple-attacks study, eletriptan 40 and 80 mg were significantly more effective in achieving a 2-hour headache response than placebo (response rate: 72.5% for eletriptan 40 mg, 70% for eletriptan 80 mg and about 23% for placebo) with a low adverse-event rate for both doses Marmura et al 2015]. Compared with all the marketed triptans, eletriptan was found to be among the most effective in two meta-analytic studies of published placebo-controlled trials [Bhambri et al 2015]. In a meta-analysis of 53 trials, rizatriptan 10 mg, eletriptan 80 mg and almotriptan 12.5 mg showed the highest probability of a significant clinical therapeutical effect [Ferrari et al 2001].…”

“…Eletriptan is commercially available at doses of 40 mg or 80 mg, and has been demonstrated to be effective nearly 30 minutes after the administration. In comparative clinical trials (discussed below) eletriptan (40 and 80 mg) showed superior or equivalent efficacy to other triptans with high safety and tolerability [McCormack et al 2006], and the most favorable cost effectiveness when compared with other drugs in its class [Sandrini et al 2009;Bhambri et al 2015].…”

“…Moreover, eletriptan (compared with placebo) has been demonstrated as effective in treating acute migraine in previous nonresponders, or patients not tolerant to sumatriptan [Färkkilä et al 2003]. Other triptan-switch studies reported eletriptan 40 mg efficacy in migraineurs who did not also respond to treatment with rizatriptan and NSAIDs [Bhambri et al 2015].…”

“…2006], and the most favorable cost effectiveness when compared with other drugs in its class [Sandrini et al . 2009; Bhambri et al . 2015].…”