The 5-hydroxytriptamine (5-HT)(1B/1D) agonists (i.e., the triptans) are highly effective in migraine but their high cost relative to other treatments necessitates careful analysis of their cost-effectiveness. The majority of pharmacoeconomic evaluations, nearly all of which deal with sumatriptan, indicate that from the societal perspective triptans are dominant: health outcomes are improved while the overall cost of migraine is reduced. However, the results are more ambiguous from the perspective of the health care payer: reductions in non-drug medical costs are unlikely to offset fully the high drug cost. Thus far, few analyses have explicitly included quality of life (QOL) in their analyses and pharmacoeconomic analyses comparing the different triptans are scant. More research is required in these areas.