Migraine preventive medications: a reappraisal |
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| Authors: | JU Adelman A Brod RL Von Seggern LK Mannix AM Rapoport |
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| Affiliation: | Department of Neurology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA and Adelman Headache Center, Greensboro NC, USA;;Department of Economics, University of North Carolina at Greensboro, Greensboro, NC, USA;;Adelman Headache Center, Greensboro, NC, USA;;The New England Headache Center, Stamford, CT, USA and Yale University School of Medicine, New Haven, CT, USA |
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| Abstract: | ![]()
Newer acute care migraine medications demonstrate improved rapidity of action, consistent effectiveness, excellent safety profiles, and rarely cause rebound headaches. Their use could decrease the need for migraine-preventive medication. The present analysis derives a formula that can be used by practitioners to determine the cost-effectiveness of various migraine-preventive medications relative to selected acute-care medications. We propose a measure called the cost-equivalent number (CEN), the number of headaches per month at which the cost of the preventive medication equals the cost savings in acute-care treatment realized by using the preventive medication. The use of the CEN individualizes the decision of whether to use a migraine-preventive medication, weighing both the efficacy and cost of the preventive medication against the cost of the acute-care medication. A CEN lower than the migraine frequency suggests that use of a preventive medication will be cost-effective. |
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| Keywords: | Cost equivalent number (CEN) migraine costs migraine prevention migraine treatments |
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