A Systematic Review and Economic Evaluation of Sumatriptan Nasal Spray Versus its Oral Tablet
-
Golnoosh Alipour Haris
,
Nayyereh Ayati
,
Ali Mehramizi
,
Peivand Ghasemzadeh
,
Mahshid Arabi
,
Shekoufeh Nikfar
Abstract
Background: Sumatriptan is one of the leading medicines in migraine treatment. This study aimed to evaluate the cost-effectiveness (in the context of Iran) of sumatriptan nasal spray versus its oral tablet for treating migraine headaches. Methods: A systematic review of the literature was performed to evaluate the clinical effectiveness of sumatriptan nasal spray compared to its oral tablet. The search was conducted in five major scientific databases from 1990 to December 2018. The effectiveness outcomes were 2-h pain relief and 24-h recurrence rate, which then were translated into Quality-Adjusted Life-year (Qaly). Local costs data were identified based on official tariffs in Iran’s public and private sectors, with ratios of %80 and %20, respectively. Costs were converted from Iranian Rial rates (IRR) to US Dollars (USD), using the currency exchange rate of 42000 IRR/USD. A 1-year decision tree was adopted for the economic evaluation, conducted from a payer perspective in the Iranian healthcare setting. The final results were presented by Incremental Cost-Effectiveness Ratio (ICER), which showed the extra cost for one additional QALY gained. ICER was compared to Iran’s national willingness to pay (WTP) threshold, which is 2709 USD. The robustness of the results was analyzed using Deterministic Sensitivity Analysis (DSA). Results: The results showed that sumatriptan nasal spray (20 mg, for $0.714 per puff) compared to sumatriptan oral tablet (50 mg, with a weighted mean price of $0.238) had an incremental QALY of 0.028 and incremental cost of $0.21 per attack, per person-year. ICER was calculated to be 2617 USD/QALY, which is below Iran’s national WTP threshold. DSA results showed that the model is mainly sensitive to the price of sumatriptan nasal spray. Conclusion: Sumatriptan nasal spray was a more cost-effective medicine than sumatriptan oral tablet in Iranian patients with migraine.
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[15] Rao AS, Gelaye B, Kurth T, Dash RD, Nitchie H, Peterlin BL. A randomized trial of ketorolac vs. sumatripan vs. placebo nasal spray (KSPN) for Acute Migraine. Headache. 2016; 56(2):331-40. [DOI:10.1111/head.12767] [PMID] [PMCID]
[16] Kaplan RM, Anderson JP. A general health policy model: Update and applications. Health Serv Res. 1988; 23(2):203-35. [PMID] [PMCID]
[17] Evans KW, Boan JA, Evans JL, Shuaib A. Economic evaluation of oral sumatriptan compared with oral caffeine/ergotamine for migraine. Pharmacoeconomics. 1997; 12(5):565-77. [DOI:10.2165/00019053-
199712050-00007] [PMID]
[18] Benzon H, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW. Practical management of pain. Philadelphia: Elsevier Health Sciences; 2013. [DOI:10.1016/C2009-0 64063-0]
[19] Tfelt-Hansen P. Efficacy and adverse events of subcutaneous, oral, and intranasal sumatriptan used for migraine treatment: a systematic review based on number needed to treat. Cephalalgia. 1998; 18(8):532-8. [DOI:10.1046/j.1468-2982.1998.1808532.x] [PMID]
[20] Ruthirago D, Julayanont P, Kim J. Translational correlation: Migraine. In: Conn PM, editor. Conn’s Translational Neuroscience. Amsterdam: Elsevier; 2017. p. 159-65. [DOI:10.1016/B978-0-12-
802381-5.00013-0]
[21] Michael Conn P. Conn’s Translational Neuroscience, (editor). Ruthirago D, Julayanont P, Kim J. Translational correlation: migraine (Chapter 7.2). Elsevier Science; 2017. pp. 159-165. https://www.google.com/books/edition/Conn_s_Translational_Neuroscience/oFGNCwAAQBAJ?hl=en
[22] Agosti R. Migraine burden of disease: From the patient’s experience to a socio-economic view. Headache. 2018; 58(Suppl 1):17-32. [DOI:10.1111/head.13301] [PMID]
[23] Adelman JU, Adelman LC, Freeman MC, Von Seggern RL, Drake J. Cost considerations of acute migraine treatment. Headache. 2004;44(3):271-85. [DOI:10.1111/j.1526-4610.2004.04060.x] [PMID]
[24] Lofland JH, Kim SS, Batenhorst AS, Johnson NE, Chatterton ML, Cady RK, et al. Cost- effectiveness and cost-benefit of sumatriptan in patients with migraine. Mayo Clinic Proc. 2001; 76(11):1093-101. [DOI:10.4065/76.11.1093] [PMID]
[25] Láinez MJ, García-Casado A, Gascón F. Optimal management of severe nausea and vomiting in migraine: Improving patient outcomes. Patient Relat Outcome Meas. 2013; 4:61-73. [DOI:10.2147/PROM.S31392] [PMID] [PMCID]
[26] Caro G, Getsios D, Caro JJ, Raggio G, Burrows M, Black L. Sumatriptan: Economic evidence for its use in the treatment of migraine, the Canadian comparative economic analysis. Cephalalgia. 2001; 21(1):12-9. [DOI:10.1046/j.1468-2982.2001.00130.x] [PMID]
[27] Legg RF, Sclar DA, Nemec NL, Tarnai J, Mackowiak JI. Cost-effectiveness of sumatriptan in a managed care population. Am J Manag Care. 1997; 3(1):117-22. [PMID]
[28] Wells N, Hettiarachchi J, Drummond M, DPhil M, Carter D, Parpia T, et al. A cost-effectiveness analysis of eletriptan 40 and 80 mg versus sumatriptan 50 and 100 mg in the acute treatment of migraine. Value Health. 2003; 6(4):438-47. [DOI:10.1046/j.1524-4733.2003.64238.x] [PMID]
[29] Becker WJ. Are the triptans for migraine therapy worth the cost? Can J Neurol Sci. 2000; 27(2):111-5. [DOI:10.1017/S0317167100052197] [PMID]
[2] Farhadi Z, Alidoost S, Behzadifar M, Mohammadibakhsh R, Khodadadi N, Sepehrian R, et al. The prevalence of migraine in Iran: A systematic review and meta-analysis. Iran Red Crescent Med J. 2016;18(10):e40061 [DOI:10.5812/ircmj.40061] [PMID] [PMCID]
[3] Rasmussen BK. Epidemiology of headache. Cephalalgia. 1995; 15(1):44-67 [DOI:10.1046/j.1468-2982.1995.1501045.x] [PMID]
[4] Weatherall MW. The diagnosis and treatment of chronic migraine. Ther Adv Chronic Dis. 2015; 6(3):115-23 [DOI:10.1177/2040622315579627] [PMID] [PMCID]
[5] Mathew NT. Serotonin 1D (5-HT1D) agonists and other agents in acute migraine. Neurol Clin. 1997; 15(1):61-83. [DOI:10.1016/S0733-8619(05)70295-4] [PMID]
[6] Diamond ML, Hettiarachchi J, Hilliard B, Sands G, Nett R. Effectiveness of eletriptan in acute migraine: Primary care for Excedrin nonresponders. Headache. 2004; 44(3):209-16. [DOI:10.1111/j.1526-4610.2004.04049.x] [PMID]
[7] Chhajed S, Sangale S, Barhate SD. Advantageous nasal drug delivery system: A review. Int J Pharm Sci Res. 2011; 2(6):1322-36. https://ijpsr.com/bft-article/advantageous-nasal-drug-deliverysystem-a-review/
[8] Rapoport AM, Freitag F, Pearlman SH. Innovative delivery systems for migraine: The clinical utility of a transdermal patch for the acute treatment of migraine. CNS Drugs. 2010; 24(11):929-40 [DOI:10.2165/11317540-000000000-00000] [PMID]
[9] Derry CJ, Derry S, Moore RA. Sumatriptan (all routes of administration) for acute migraine attacks in adults overview of Cochrane reviews. Cochrane Database Syst Rev. 2014; 2014(5):CD009108 [DOI:10.1002/14651858.CD009108.pub2] [PMID] [PMCID]
[10] Derry J, Derry S, Moore RA. Sumatriptan (oral route of administration) for acute migraine attacks in adults. Cochrane Database Syst Rev. 2012; 2012(2):CD008615. [DOI:10.1002/14651858.CD008615.pub2] [PMID] [PMCID]
[11] Derry CJ, Derry S, Moore RA. Sumatriptan (intranasal route of administration) for acute migraine attacks in adults. Cochrane Database Syst Rev. 2012; 2012(2):CD009663. [DOI:10.1002/14651858.CD009663] [PMID] [PMCID]
[12] Xu R, Insinga RP, Golden W, Hu XH. Euroqol (EQ-5D) health utility scores for patients with migraine. Qual Life Res. 2011; 20(4):601-8. [DOI:10.1007/s11136-010-9783-5] [PMID]
[13] Khajehpour B. Domestic political reforms and private sector activity in Iran. 2000; 67(2):577-98. https://www.jstor.org/stable/40971485
[14] Central Bank of the Islamic Republic of Iran. Exchange Rate. In: ICentral Bank of the Islamic Republic of Iran, ed. Available from: https://www.cbi.ir/default_en.aspx2018. https://www.cbi.ir/GenericError.htm?aspxerrorpath=/default_en.aspx2018.
[15] Rao AS, Gelaye B, Kurth T, Dash RD, Nitchie H, Peterlin BL. A randomized trial of ketorolac vs. sumatripan vs. placebo nasal spray (KSPN) for Acute Migraine. Headache. 2016; 56(2):331-40. [DOI:10.1111/head.12767] [PMID] [PMCID]
[16] Kaplan RM, Anderson JP. A general health policy model: Update and applications. Health Serv Res. 1988; 23(2):203-35. [PMID] [PMCID]
[17] Evans KW, Boan JA, Evans JL, Shuaib A. Economic evaluation of oral sumatriptan compared with oral caffeine/ergotamine for migraine. Pharmacoeconomics. 1997; 12(5):565-77. [DOI:10.2165/00019053-
199712050-00007] [PMID]
[18] Benzon H, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW. Practical management of pain. Philadelphia: Elsevier Health Sciences; 2013. [DOI:10.1016/C2009-0 64063-0]
[19] Tfelt-Hansen P. Efficacy and adverse events of subcutaneous, oral, and intranasal sumatriptan used for migraine treatment: a systematic review based on number needed to treat. Cephalalgia. 1998; 18(8):532-8. [DOI:10.1046/j.1468-2982.1998.1808532.x] [PMID]
[20] Ruthirago D, Julayanont P, Kim J. Translational correlation: Migraine. In: Conn PM, editor. Conn’s Translational Neuroscience. Amsterdam: Elsevier; 2017. p. 159-65. [DOI:10.1016/B978-0-12-
802381-5.00013-0]
[21] Michael Conn P. Conn’s Translational Neuroscience, (editor). Ruthirago D, Julayanont P, Kim J. Translational correlation: migraine (Chapter 7.2). Elsevier Science; 2017. pp. 159-165. https://www.google.com/books/edition/Conn_s_Translational_Neuroscience/oFGNCwAAQBAJ?hl=en
[22] Agosti R. Migraine burden of disease: From the patient’s experience to a socio-economic view. Headache. 2018; 58(Suppl 1):17-32. [DOI:10.1111/head.13301] [PMID]
[23] Adelman JU, Adelman LC, Freeman MC, Von Seggern RL, Drake J. Cost considerations of acute migraine treatment. Headache. 2004;44(3):271-85. [DOI:10.1111/j.1526-4610.2004.04060.x] [PMID]
[24] Lofland JH, Kim SS, Batenhorst AS, Johnson NE, Chatterton ML, Cady RK, et al. Cost- effectiveness and cost-benefit of sumatriptan in patients with migraine. Mayo Clinic Proc. 2001; 76(11):1093-101. [DOI:10.4065/76.11.1093] [PMID]
[25] Láinez MJ, García-Casado A, Gascón F. Optimal management of severe nausea and vomiting in migraine: Improving patient outcomes. Patient Relat Outcome Meas. 2013; 4:61-73. [DOI:10.2147/PROM.S31392] [PMID] [PMCID]
[26] Caro G, Getsios D, Caro JJ, Raggio G, Burrows M, Black L. Sumatriptan: Economic evidence for its use in the treatment of migraine, the Canadian comparative economic analysis. Cephalalgia. 2001; 21(1):12-9. [DOI:10.1046/j.1468-2982.2001.00130.x] [PMID]
[27] Legg RF, Sclar DA, Nemec NL, Tarnai J, Mackowiak JI. Cost-effectiveness of sumatriptan in a managed care population. Am J Manag Care. 1997; 3(1):117-22. [PMID]
[28] Wells N, Hettiarachchi J, Drummond M, DPhil M, Carter D, Parpia T, et al. A cost-effectiveness analysis of eletriptan 40 and 80 mg versus sumatriptan 50 and 100 mg in the acute treatment of migraine. Value Health. 2003; 6(4):438-47. [DOI:10.1046/j.1524-4733.2003.64238.x] [PMID]
[29] Becker WJ. Are the triptans for migraine therapy worth the cost? Can J Neurol Sci. 2000; 27(2):111-5. [DOI:10.1017/S0317167100052197] [PMID]
| Files | ||
| Issue | Vol 7 No 3/4 (2021) | |
| Section | Review Article(s) | |
| Keywords | ||
| Sumatriptan nasal spray Sumatriptan oral tablet Migraine Cost-utility Cost-effectiveness | ||
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How to Cite
1.
Alipour Haris G, Ayati N, Mehramizi A, Ghasemzadeh P, Arabi M, Nikfar S. A Systematic Review and Economic Evaluation of Sumatriptan Nasal Spray Versus its Oral Tablet. JPPM. 2021;7(3/4):61-69.
