title: Migraine preventive medications: a reappraisal.
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.
authors.affiliation: Department of Neurology, School of Medicine, University of North Carolina, Chapel Hill, USA.
authors.forename: J U
authors.initials: JU
authors.lastname: Adelman
authors.forename: A
authors.initials: A
authors.lastname: Brod
authors.forename: R L
authors.initials: RL
authors.lastname: Von Seggern
authors.forename: L K
authors.initials: LK
authors.lastname: Mannix
authors.forename: A M
authors.initials: AM
authors.lastname: Rapoport
mesh_terms: D003362:Cost-Benefit Analysis; D004358:Drug Therapy / Q000191:economics; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy* / Q000191:economics* / Q000517:prevention & control; D018803:Models, Economic