Economic implications of early treatment of migraine with sumatriptan tablets

Background: Early treatment of migraine with sumatriptan 50 mg and 100 mg, while pain is mild, has been reported to enhance pain-free response 2 hours and 4 hours postdose and sustained pain-free response 2 to 24 hours postdo se compared with treatment when pain has become moderate to severe. Early t reatment with sumatriptan 50 mg and 100 mg also resulted in less redosing, which translated to a reduction in the mean number of doses used per migrai ne episode. Objective: We examined the economic implications of early treatment with su matriptan 50 mg and 100 mg while pain is mild versus treatment when pain ha s become moderate to severe. Methods: Using data from retrospective analyses of a dose-ranging clinical trial of sumatriptan (protocol S2CM09) involving 1003 patients, we estimate d the mean cost per treatment success for a hypothetical population of 1000 migraine patients who received treatment with sumatriptan 50-mg or 100-mg tablets early while pain was mild versus treatment when pain had become mod erate to severe. Results: With a conservative estimate of migraine frequency of 1.5 episodes per month, the total cost of early migraine treatment with sumatriptan 50 mg and 100 mg was reduced by $31.68 and $20.16, respectively, per patient p er year. The average cost per pain-free treatment success was reduced by 32 % to 57% with sumatriptan 50 mg and 100 mg if migraines were treated while pain was mild in intensity versus when pain had become moderate to severe. Conclusions: Treatment of migraine with sumatriptan 50-mg and 100-mg tablet s is effective regardless of whether pain is mild, moderate, or severe. How ever, initiating treatment while pain is mild may be more cost-effective th an delaying treatment until pain has become moderate to severe.