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Qual Life Res. 2019 Mar 28. doi: 10.1007/s11136-019-02163-3. [Epub ahead of print]

Health state utilities associated with attributes of migraine preventive treatments based on patient and general population preferences.

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Patient-Centered Research, Evidera, 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD, 20814, USA.
Modeling and Simulation, Evidera, Bethesda, MD, USA.
Novartis Pharma AG, Basel, Switzerland.
Basildon and Thurrock University Hospitals and Queen Mary University, London, UK.
NIHR-Wellcome Trust King's Clinical Research Facility, King's College London, London, UK.



While previous studies have estimated health state utilities associated with migraine severity and frequency, migraine treatments vary in other ways that may have an impact on patients' quality of life, preference, and utility. The purpose of this study was to estimate utilities associated with migraine treatment attributes including route of administration and treatment-related adverse events (AEs).


In time trade-off interviews, migraine patients and general population participants in the UK valued health state vignettes drafted based on literature, medication labels, and clinician interviews. All respondents valued migraine health states varying in route of administration. Each participant also valued eight health states (randomly selected from a total of 15) that added the description of an AE to a migraine health state.


A total of 400 participants completed interviews (200 general population [49.0% female; mean age = 43.6 years]; 200 migraine patients [74.5% female; mean age = 45.8 years]). In the general population sample, mean utilities of health states without aura were 0.79 with daily oral medication, 0.78 with one injection per month, and 0.72 with 31-39 injections once every 3 months. The greatest disutilities (i.e., decreases in utility) were for AEs associated with oral medications (e.g., - 0.060 [fatigue] and - 0.098 [brain fog]). Differences among health states followed the same pattern in the patient sample as in the general population sample.


Utilities estimated from the general population sample may be used to represent route of administration and AEs in cost-utility models. Results from the patient sample indicate that these treatment characteristics have an impact on patient preference.


Adverse events; Migraine; Route of administration; Time trade-off; Treatment process utilities; Utility


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