The following is a summary of “Early and annual projected savings from anti-CGRP monoclonal antibodies in migraine prevention: a cost-benefit analysis in the working-age population,” published in the February 2024 issue of Pain by Lazaro-Hernandez et al.

Researchers conducted a retrospective study to weigh the financial advantages and disadvantages of anti-CGRP monoclonal antibodies (MAbs) for preventing migraine in working-age individuals.

They involved consecutive migraine patients who received treatment with anti-CGRP MAbs, namely erenumab, fremanezumab, and galcanezumab, according to the National reimbursement policy at a specialized headache clinic. Migraine characteristics and the Work Productivity and Activity Impairment (WPAI) scale were compared between baseline (M0) and after 3 (M3) and 6 months (M6) of treatment. Indirect costs (absenteeism and presenteeism) at each time point were calculated using WPAI and the municipal average hourly wage, while direct costs (emergency visits, acute medication use) were also analyzed. A cost-benefit analysis led to an annual projection based on findings regarding MAb treatment costs and savings.

The results showed 256 treated working-age patients, 148 were employed (89.2% female; mean age 48.0 ± 8.5 years), with 41.2% (61/148) being responders (> 50% reduction in monthly headache days (MHD)). Significant decreases in absenteeism (P<0.001) and presenteeism (P<0.001) were observed between M0 and M3/M6. The average savings in indirect costs per patient at M3 were 105.4 euros/month for absenteeism and 394.3 euros/month for presenteeism, similar to M6. After considering the monthly cost of anti-CGRP MAbs, the cost-benefit analysis indicated savings of 159.8 euros per patient at M3, with an annual projected savings of 639.2 euros/patient. Both responders and partial responders (30–50% reduction in MHD) showed a positive cost-benefit balance. The overall savings of the group at M3/M6 offset the negative cost-benefit balance for non-responders (< 30% reduction in MHD).

Despite their initial expense, they concluded that anti-CGRP MAbs quickly yielded cost savings, suggesting broader use and further research globally.

Source:thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-024-01727-0