Subcutaneous sumatriptan compared with usual acute treatments for migraine: clinical and pharmacoeconomic evaluation

Cost-effectiveness and cost per successful treatment has been evaluated in 186 outpatients randomised to treat moderate to severe migraine attacks eit her with subcutaneous sumatriptan 6 mg (n = 97) or with their current thera py (n = 89) during an open, multicentre study of 3 months, Within 2 hours, headache severity decreased to none/mild in 86% of all attacks in the sumat riptan group (STG) compared to 25% in the customary group (CTG). Migraine w as alleviated earlier in the STG than in the CTG (median 3.78 vs. 13.39 hou rs, p < 0.0001). The direct and total cost of treatment was 133 and 2012 BF , respectively, in the CTG and 1400 and 2522 BF, respectively in the STG. M easuring the effectiveness of earlier pain relief with sumatriptan, the inc remental cost-effective ratios for direct and total cost were 132 and 53 BF per hour of relieved pain, respectively For this price, significantly more sumatriptan patients improved their quality, of life by more than 20% (61. 6 vs. 20.6% patients, p < 0.001) and less sumatriptan patient consulted a m edical professional (11.3 vs. 29.2% patients, p < 0.01) used less medicatio n for adverse events (6.2 vs. 22.5%, p < 0.001) and suffered less from asso ciated migraine symptoms. The median number of hours of diminished work-eff iciency, (3 vs. 7 hours, p < 0.01) or of suspension of non-professional act ivity (10 vs. 24 hours, p < 0.001) was also significantly lower in the STG. The total cost per successfully treated patient was lower in the STG. Suma triptan is more effective, provides a better quality of life, reduces healt h care resource utilisation, ann improves work productivity as compared to the CTG, thereby resulting in a favourable cost-effectiveness ratio.