Economic consequences of migraine in Sweden and implications for the cost-effectiveness of onabotulinumtoxinA (Botox) for chronic migraine in Sweden and Norway

Table 8 Sensitivity analyses

	Model input		ICER (EUR)
	Base case	Sensitivity	Sweden	Norway
*Base case*			18,506	19,954
*Analyses of structural changes and altering assumptions*
Indirect costs	Not included	Included	Dominating	Dominating
Discount rate costs and health effects	3% (Sweden) and 4% (Norway)	0%	17,931	19,250
Discount rate costs and health effects	3% (Sweden) and 4% (Norway)	5%	18,893	20,132
Stopping rule	30% reduction in 2 cycles	No stopping rule	23,412	24,545
		50% reduction in 2 cycles	17,666	19,163
		0% reduction in 2 cycles	21,825	23,070
Population	All patients	≥1 prior prophylactic	15,160	16,900
Population	All patients	≥3 prior prophylactics	15,764	17,532
Utilities	Estimated from COI database	REPOSE [56]	14,565	15,702
		PREEMPT [18, 24]	15,634	16,804
		IBMS	18,219	19,644
Time horizon	10 years	5 years	21,481	22,645
*Analysis mirroring previous erenumab analysis*
*Norwegian (NOMA) and Swedish (TLV) erenumab analyses:* 10-year time horizon^a, indirect costs not included, ≥3 prior prophylactics^b, stopping rule 30% reduction in 2 cycles, utilities mapped from MSQ to EQ-5D^c			16,625	18,462

^aNOMA utilised a 10-year time horizon, while the TLV time horizon was confidential. We therefore chose to undertake the analyses using a 10-year time horizon
^bThe TLV analyses were undertaken in a population with ≥ 2 prior prophylactics and 30% stopping rules. There is no available data for this combination of population and stopping rule for Botox. The NOMA analysis was however undertaken in a population of ≥ 3 prior prophylactics. We chose to undertake the analyses the ≥ 3 prior prophylactics population, and to use the 30% stopping rule, as NOMA argued for the importance of this specific rule
^cThe CGRP analyses utilised utilities mapped from MSQ to EQ-5D, based on clinical trials