Authors' objectives:

To evaluate the cost and efficacy of sumitriptan from both the societal and Ministry of Health perspectives using models for cost-effectiveness, cost-utility, and cost benefit analyses.

Authors' results and conclusions: 1. Sumatriptan is effective as an oral tablet and as a subcutaneous injection for the management of acute migraine, achieving a satisfactory response in 56% and 70% of patients with each form of administration, respectively. 2. Both forms of sumatriptan were associated with recurrences, occurring in 41% and 32% of cases, respectively. The rates among comparators varied from 0% to 30%. 3. The selected comparators for oral sumatriptan were oral ergotamine/caffeine (Cafergot), effective in 38% of episodes, and oral acetylsalicylic acid (ASA) plus metoclopramide, which was 44% effective. Sumatriptan was more expensive than either alternative. 4. Subcutaneous sumatriptan had a higher rate of response than its comparators, dihydroergotamine (49% efficacy) and intranasal butorphanol (50% efficacy). However, it also was more expensive than these comparators. 5. From the societal perspective, the cost-effectiveness analysis showed that oral Sumatriptan was the dominant alternative (more effective, less costly) versus oral ergotamine/caffeine when the drug costs, recurrent headaches, health system costs and personal productivity losses were assessed. From a Ministry of Health perspective the substitution of Cafergot with oral sumatriptan resulted in a cost-utility ratio of $29,000 per quality-adjusted life year (QALY). 6. Oral sumatriptan is not statistically more effective than the combination acetysalicylic acid plus metoclopramide when recurrences are taken into account. 7. Subcutaneous sumatriptan had a cost-utility ratio of $24,500/QALY (societal perspective) and $62,00/QALY (payer perspective) versus subcutaneous dihydroergotamine. The comparison to intranasal butorphanol produced cost-utility ratios of $27,500/QALY and $66,100/QALY, respectively.

Project Status: Completed

URL for project: https://www.ccohta.ca/

Year Published: 1997

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Coordinating Office for Health Technology Assessment

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Coordinating Office for Health Technology Assessment