The Role of Pharmacoeconomics in Formulary Management:Triptan Case Study for Migraine

The use of pharmacoeconomic (PE) evaluations for formulary decision-making has become increasingly common. When a new drug is being considered for inclusion on a formulary, the drug is compared with other available alternatives with respect to efficacy and effectiveness, safety, and cost. The 5-hydroxytryptamine agonists, also known as triptans, are being used to a greater extent as first-line abortive therapies for patients with migraine headache. Triptans of fer several advantages over previous antimigraine therapies. The seven currently available triptans offer clear evidence of improved clinical and economic (costsaving) outcomes compared with other abortive migraine therapies, such as ergotamine alkaloids; however, the clinical and economic benefits of triptans are less clear. In this article, we describe a triptan case study that introduces a systematic methodology to help formulary decisionmakers in evaluating the cost-effectiveness of drugs within a category by relying on readily available data.