Use of decision analysis in modeling the cost-effectiveness of oral vs SC sumatriptan

Sumatriptan products have been shown to be effective agents in treating migraine headaches. This month's column presents a cost-effectiveness analysis of two different formulations of sumatriptan using a decision-tree approach. The analysis introduces a new concept, rank-order stability analysis (ROSA), in assessing the sensitivity of a decision-tree model. The ROSA showed that the results of the cost-effectiveness analysis were elastic to variation in the primary clinical efficacy measure. However, because the incremental cost-effectiveness ratio was not large, most health care organizations will likely want to make both sumatriptan products available.