Cost-effectiveness analysis of rimegepant for on-demand acute treatment of migraine in China

TL;DR

This study evaluates whether rimegepant is a cost-effective treatment for migraines in China and finds that its current price is too high to be considered cost-effective.

Contribution

The study provides a cost-effectiveness analysis of rimegepant for migraine treatment in China using a decision tree model and clinical trial data.

Findings

Rimegepant adds 0.0018 quality-adjusted life days with an ICER of 122,166.07 CNY/QALD.

The drug is not cost-effective at its current price of 219.00 CNY per dose in China.

A price reduction to 1.32 CNY per dose would make rimegepant cost-effective.

Abstract

This study assesses the cost-effectiveness of rimegepant for the on-demand acute treatment of migraine in the Chinese population, focusing on headache relief within a 2 h timeframe. Utilizing data from Phase III clinical trials on rimegepant involving Asian populations, this analysis aims to provide essential insights for healthcare decision-making in the context of migraine management in China.

Employing a decision tree model, this research evaluates the cost-effectiveness of rimegepant over a concise 2 h period, exclusively considering its direct market price of 219.00 CNY per dose for on-demand, single-use treatment upon approval in China. This model is based on pain relief outcomes from a clinical trial, categorizing health outcomes by the achievement of pain freedom and alleviation from the most bothersome symptom within two hours post-administration.

The study unveils that rimegepant adds 0.0018 quality-adjusted life days (QALD) with an incremental cost-effectiveness ratio (ICER) of 122,166.07 CNY/QALD. Against a daily cost-effectiveness threshold derived from the 2023 per capita GDP of China (734.45 CNY/day), rimegepant falls short of proving its cost-effectiveness. A significant price reduction to approximately 1.32 CNY per dose is required for rimegepant to be considered cost-effective within this framework. Furthermore, a series of sensitivity analyses were conducted to validate the robustness of these results.

While rimegepant shows clinical efficacy in providing rapid relief from migraine symptoms, its current pricing exceeds the threshold for cost-effectiveness in the Chinese healthcare setting. This study underscores the need for price adjustments to enhance the accessibility and economic viability of new migraine treatments.

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