ECONOMIC-EVALUATION OF ORAL SUMATRIPTAN COMPARED WITH ORAL CAFFEINE ERGOTAMINE FOR MIGRAINE/

We conducted an economic comparison of oral sumatriptan with oral caff eine/ergotamine in the treatment of patients with migraine. Cost-effec tiveness, cost-utility and cost-benefit analyses were conducted from s ocietal and health-departmental perspectives. A decision tree was used . Utilities were assigned to health states using the Quality of Well-B eing Scale. Simple and probabilistic sensitivity analyses were also ca rried out. From a societal perspective, using sumatriptan instead of c affeine/ergotamine resulted in an incremental cost-effectiveness ratio of -25 Canadian dollars ($Can) per attack aborted, an incremental cos t-utility ratio of -$Can7507 per quality-adjusted life-year (QALY), an d a net economic benefit of $Can42 per patient per year (1995 values). From the perspective of the health department, the incremental cost-e ffectiveness ratio was $Can98 per attack aborted, the incremental cost -utility ratio was $Can29 366 per QALY; the grade of recommendation ba sed on past decisions regarding health technology for adoption into he alth insurance plans was 'moderate'. Sensitivity analysis showed that the results were robust to relatively large changes in the input varia bles. The incremental health benefits obtained from using oral sumatri ptan rather than oral caffeine/ergotamine were achieved at moderately acceptable incremental costs, if past decisions on the adoption of oth er health technologies are used as a guide.