Adjunctive VNS Proves Cost-Effective for Migraine
Noninvasive vagus nerve stimulation using gammaCore, in addition to standard of care for acute treatment of migraine, is more cost-effective for payers compared with standard of care alone, according to an analysis published in The American Journal of Managed Care.
“GammaCore is used adjunctively with current standard of care and abortive medications and has shown to be superior in acute treatment of episodic migraine compared to sham,” researchers wrote. “However, the economic impact has not [previously] been characterized for this indication.”
Researchers analyzed the cost-effectiveness of adjunctive gammaCore compared with standard of care alone using a 1-year time horizon. The mean cost for gammaCore plus standard of care, they found, was $9678 compared with $10,010 for standard of care without gammaCore.
“The cost-effectiveness, particularly among high-demand migraineurs who cost payers the most, is driven by the unique combination of gammaCore’s superiority in efficacy, favorable safety profile, improvement in quality of life, and effect of reducing overall healthcare needs and costs for patients when gammaCore consistently effective.”
A secondary analysis found initiating preventive erenumab only after patients fail to improve with acute treatment using gammaCore or standard of care was more cost-effective than directly starting patients on erenumab.
“Because gammaCore is dominant, its use represents savings to payers and patients as a treatment option and a component of treatment sequence strategies involving back-up preventive agents,” researchers wrote. “These findings serve as additional robust economic evidence to support the need to update current migraine treatment guidelines and patient coverage policies.”
GammaCore maker electroCore funded the study, which involved researchers affiliated with the company.
—Jolynn Tumolo
Reference
Mwamburi M, Tenaglia AT, Leibler EJ, Staats PS. Cost-effectiveness of noninvasive vagus nerve stimulation for acute treatment of episodic migraine and role in treatment sequence strategies. The American Journal of Managed Care. 2018;24(24 Suppl):S527-S533.
