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Table 5 Health effects, costs and cost effectiveness of migraine management strategies in China, India, Russian Federation and Zambia

From: Cost-effectiveness analysis of interventions for migraine in four low- and middle-income countries

   China India Russian Federation Zambia
  Target coverage* Healthy life years gained per year (per 1 m popn)   Cost per year per capita (US$)   Cost per healthy life year gained (US$)   ICER (US$) Healthy life years gained per year (per 1 m popn)   Cost per year per capita (US$)   Cost per healthy life year gained (US$)   ICER (US$) Healthy life years gained per year (per 1 m popn)   Cost per year per capita (US$)   Cost per healthy life year gained (US$)   ICER (US$) Healthy life years gained per year (per 1 m popn)   Cost per year per capita (US$)   Cost per healthy life year gained (US$)   ICER (US$)
A. ACUTE MANAGEMENT (NON-SPECIFIC DRUGS)
Simple analgesics (e.g. ASA 1 g) 90% 530 $ 0.02 $ 34 $ 35 673 $ 0.05 $ 73 $ 75 1223 $ 0.07 $ 53 $ 63 1244 $ 0.03 $ 24 $ 24
With consumer education   597 $ 0.03 $ 53 $ 204 757 $ 0.06 $ 77 $ 105 1376 $ 0.19 $ 136 $ 801 1400 $ 0.12 $ 85 $ 575
B. ACUTE MANAGEMENT (SPECIFIC DRUGS)
Sumatriptan (50 mg) 90% 152 $ 2.14 $ 14,061    193 $ 1.20 $ 6,201    352 $ 12.55 $ 35,684    358 $ 2.62 $ 7,330   
With consumer education   212 $ 2.16 $ 10,159    269 $ 1.21 $ 4,485    490 $ 12.67 $ 25,869    498 $ 2.71 $ 5,442   
With provider training   178 $ 2.16 $ 12,129    226 $ 1.20 $ 5,335    410 $ 12.64 $ 30,804    417 $ 2.64 $ 6,329   
With consumer education and provider training   248 $ 2.17 $ 8,762    314 $ 1.21 $ 3,859    571 $ 12.76 $ 22,330    581 $ 2.73 $ 4,698   
Almotriptan (12.5 mg) 90% 196 $ 5.59 $ 28,546    249 $ 14.55 $ 58,533    452 $ 23.38 $ 51,728    460 $ 8.82 $ 19,187   
With consumer education   273 $ 5.61 $ 20,544    346 $ 14.56 $ 42,049    630 $ 23.51 $ 37,332    640 $ 8.91 $ 13,915   
With provider training   229 $ 5.61 $ 24,528    290 $ 14.56 $ 50,187    527 $ 23.47 $ 44,508    536 $ 8.84 $ 16,482   
With consumer education and provider training   318 $ 5.62 $ 17,652    404 $ 14.56 $ 36,053    735 $ 23.60 $ 32,121    747 $ 8.93 $ 11,953   
C. ACUTE STEPPED CARE MANAGEMENT
ASA (1 g) + sumatriptan (50 mg) 90% 431 $ 2.52 $ 5,840    547 $ 1.62 $ 2,964    994 $ 15.71 $ 15,811    1011 $ 2.95 $ 2,917   
With consumer education   600 $ 2.53 $ 4,215    761 $ 1.63 $ 2,139    1384 $ 15.84 $ 11,440    1408 $ 3.04 $ 2,158   
With provider training   503 $ 2.53 $ 5,033    638 $ 1.62 $ 2,548    1160 $ 15.80 $ 13,630    1179 $ 2.97 $ 2,517   
With consumer education and provider training   700 $ 2.54 $ 3,633 $ 24,271 888 $ 1.63 $ 1,839 $ 11,996 1615 $ 15.93 $ 9,861 $ 65,920 1643 $ 3.06 $ 1,861 $ 12,102
D. PROPHYLAXIS + ACUTE MANAGEMENT
ASA (1 g) + amitriptyline (100 mg) 30% 112 $ 0.18 $ 1,649    145 $ 0.26 $ 1,795    275 $ 1.45 $ 5,264    305 $ 0.24 $ 773   
With consumer education   189 $ 0.20 $ 1,047    245 $ 0.27 $ 1,098    465 $ 1.57 $ 3,377    515 $ 0.32 $ 631   
With provider training   130 $ 0.20 $ 1,517    169 $ 0.26 $ 1,565    321 $ 1.54 $ 4,790    355 $ 0.25 $ 716   
With consumer education and provider training   220 $ 0.21 $ 959    286 $ 0.27 $ 957    543 $ 1.66 $ 3,059    601 $ 0.34 $ 573   
Sumatriptan (50 mg) + amitriptyline (100 mg) 30% 49 $ 0.73 $ 14,872    63 $ 0.53 $ 8,329    121 $ 3.95 $ 32,633    134 $ 1.09 $ 8,102   
With consumer education   83 $ 0.74 $ 8,962    107 $ 0.54 $ 5,010    205 $ 4.07 $ 19,902    227 $ 1.18 $ 5,188   
With provider training   68 $ 0.74 $ 10,908    88 $ 0.53 $ 6,049    168 $ 4.04 $ 24,027    186 $ 1.11 $ 5,937   
With consumer education and provider training   115 $ 0.76 $ 6,571    149 $ 0.54 $ 3,637    284 $ 4.16 $ 14,644    315 $ 1.19 $ 3,796   
ASA + sumatriptan + amitriptyline 30% 103 $ 0.80 $ 7,740    133 $ 0.73 $ 5,467    248 $ 4.55 $ 18,319    275 $ 1.20 $ 4,362   
With consumer education   174 $ 0.81 $ 4,657    226 $ 0.74 $ 3,273    420 $ 4.67 $ 11,128    465 $ 1.29 $ 2,773   
With provider training   143 $ 0.81 $ 5,668    185 $ 0.73 $ 3,961    345 $ 4.64 $ 13,449    382 $ 1.22 $ 3,191   
With consumer education and provider training   241 $ 0.82 $ 3,409    313 $ 0.74 $ 2,371    583 $ 4.76 $ 8,166    645 $ 1.31 $ 2,026   
  1. *Target coverage for acute management in Zambia set at 80%.
  2. ICER=Incremental cost-effectiveness ratio. All interventions without an ICER value are 'dominated’.