P085 Rethinking migraine:will shifting the emphasis towards preventative treatment of migraine, using new CGRP-targeting medicines, be of added value to society from a health economics perspective?

Objective: The calcitonin gene-related peptide [CGRP] receptor antagonists are new therapies with demonstrated efficacy both in treatment and prevention of migraine attacks. Their place among the range of treatments needs to be established. CGRP-targeting medicines include gepants (small molecular antagonists) and anti-CGRP antibodies. Our objective is to assess the evidence of cost-effectiveness of CGRP-targeting medicines in migraine prevention (alone or in combination with other approaches) as a prerequisite for evaluating the marginal cost-effectiveness of introducing these CGRP-targeting medicines into the range of preventative measures, both pharmacological and non-pharmacological. Methods: We will first conduct scoping literature reviews of (a) cost-of-illness of episodic (EM) and chronic (CM) migraine and (b) cost-effectiveness of preventative treatments for EM and CM, with particular focus on CGRP-targeting medicines. Subsequently we will conduct decision analytic modelling. Results: Preliminary results from the literature reviews and our plans for the economic modelling will be presented. Conclusion: In clinical trials, not all patients have benefited from the preventative effects of CGRP-targeting medicines. At the same time, these newly-developed drugs are relatively costly. In these circumstances, the public-health benefits of introducing them are uncertain. These and further studies are needed to understand whether, and by how much, CGRP-targeting medicines, when optimally introduced among other therapeutic options, will improve outcomes at what increase in costs.