Cost of rimegepant and lasmiditan associated adverse events, for acute treatment in migraine in Spain

To compare the cost of adverse events (AEs) associated with the acute treatment with rimegepant (RIM) versus lasmiditan (LAS) for migraine in Spain. A probabilistic modeling analysis was performed, using second-order Monte Carlo simulations, from the perspective of the Spanish National Health System (SNHS). The cost per patient of all AEs described with RIM or LAS in 12 clinical trials, obtained through a systematic review, was analyzed. Several sensitivity analyzes (among them, a matching adjusted indirect comparison -MAIC- of the two long-term studies) were also performed. The cost of AEs management (€ 2024) was obtained from Spanish sources. The probabilistic model estimated that RIM compared to LAS would generate savings of €612.79 (95% CI €159.49–1339.43) per treated patient with migraine, in a treatment period of 6.11 ± 3.25 months, €98.54 per month. In the MAIC analysis, a saving per patient of €697.04 (95% CI: €514.44–879.04) was obtained in a treatment period of 12.4 months. The probability of RIM saving in all analysis was 100%. In accordance with this model, the favorable safety profile of RIM compared to LAS would generate savings for the SNHS in health-care resources in all the scenarios considered. According to a probabilistic model based on the analysis of clinical trials that examined all AEs observed in patients receiving acute treatment with RIM and LAS, the favorable safety profile of RIM compared to LAS would generate savings for the Spanish NHS in healthcare resources in all the scenarios considered. These savings per patient would range from approximately €612 to €697, depending on the type of analysis performed. The maximum savings per patient would be approximately €752.