Submited on: 13 Oct 2010 05:24:02 AM GMT
Published on: 13 Oct 2010 10:01:38 AM GMT
Author`s reply
Posted by Dr. Manuel Hens on 20 Apr 2011 12:52:42 PM GMT

We thanks the comments made by Dr. Zavos. Nevertheless, some precisions must be made about them. It is known that cost-effectiveness analyses of therapies can vary from country to country in Western Europe and that these variations are not systematic (1, 2). Therefore, cost-effectiveness analyses, even those performed in a single country, can contribute to international comparisons, providing a wider perspective, according to the aims expressed by the European Commission and European Parliament on patient mobility and healthcare developments (3). Moreover our study does not contradict any of the evidences that established the advantages of rizatriptan compared to naratriptan, and it provides cost-effectiveness evidences that support them.


It is additionally necessary to mention some comments made by Dr. Zavos that, from our point of view, can reflect a severe lack of knowledge on this matter. Topiramate is not indicated for the treatment of acute migraine, but for its prevention, and this is well known by both neurologists and  general practitioners. Regarding telcagepant, another drug that was suggested in Dr. Zavos’ comments, a cost-effectiveness study about it cannot be performed until this drug is marketed and its current price is established.




1. Barbieri M, Drummond M, Willke R, Chancellor J, Jolain B, Towse A. Variability of Cost-Effectiveness Estimates for Pharmaceuticals in Western Europe: Lessons for Inferring Generalizability. Value Health 2005;8:10-23.


2. Drummond M, Barbieri M, Cook J et al. Transferability of economic evaluations across jurisdictions: ISPOR Good Research Practices Task Force report. Value Health 2009;12:409-18.


3. Forchielli F, Fusco M, Pessina EA, Domeniconi W, Ricciardi W. Study on Patient Mobility in the European Union. Study on Legislative Proposals on Patients’ Rights in Cross-Border Health Care. Analysis of the Proposal for a Directive of the European Parliament and of the Council on the application of patients’ rights in cross-border health {COM(2008) 414 final} and of the Communication from the Commission A Community framework on the application of patient’s rights in cross-border healthcare {COM(2008) 415 final}. Brussels: Policy Department, Economic and Scientific Policy, European Parliament, 2008.

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