Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care

Other literature type, Article English OPEN
Wonderling, D ; Vickers, AJ ; Grieve, R ; McCarney, R (2004)
  • Publisher: BMJ Publishing Group
  • Related identifiers: doi: 10.1136/bmj.38033.896505.EB
  • Subject: Primary Care
    mesheuropmc: health care economics and organizations

OBJECTIVE: To evaluate the cost effectiveness of acupuncture in the management of chronic headache. DESIGN: Cost effectiveness analysis of a randomised controlled trial. SETTING: General practices in England and Wales. PARTICIPANTS: 401 patients with chronic headache, predominantly migraine. Interventions Patients were randomly allocated to receive up to 12 acupuncture treatments over three months from appropriately trained physiotherapists, or to usual care alone. MAIN OUTCOME MEASURE: Incremental cost per quality adjusted life year (QALY) gained. RESULTS: Total costs during the one year period of the study were on average higher for the acupuncture group ( pound 403; $768; 598) than for controls ( pound 217) because of the acupuncture practitioners' costs. The mean health gain from acupuncture during the one year of the trial was 0.021 quality adjusted life years (QALYs), leading to a base case estimate of pound 9180 per QALY gained. This result was robust to sensitivity analysis. Cost per QALY dropped substantially when the analysis incorporated likely QALY differences for the years after the trial. CONCLUSIONS: Acupuncture for chronic headache improves health related quality of life at a small additional cost; it is relatively cost effective compared with a number of other interventions provided by the NHS.
  • References (25)
    25 references, page 1 of 3

    1 Blau JN, Drummond MF. Migraine. London: Office of Health Economics, 1991.

    2 Bosanquet N, Zammit-Lucia J. Migraine: prevention or cure? Br J Med Econ 1992;2:81- 91.

    3 Solomon GD, Price KL. Burden of migraine: a review of its socioeconomic impact, PharmacoEconomics 1997;11(suppl 1):1-10.

    4 Cull RE, Wells NE, Moiechevich ML. The economic cost of migraine. Br J Med Econ 1992;2:81-91.

    5 Melchart D, Linde K, Fischer P, Berman B, White A, Vickers A, et al. Acupuncture for idiopathic headacnes. Cochrane Database Syst Rev 2001;(1):CD001218.

    6 Vickers AJ, Rees RW, Zollman CE, McCarney R, Smith C, Ellis N, et al. Acupuncture for migraine and chronic tension headache in primary care: a large, pragmatic, randomised trial. BMJ 2004;328:000.

    7 Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002;21(2):271-92.

    8 Office for National Statistics. First release: consumer prices indices May 2003. London: ONS, 2003.

    9 Netten A, Curtis L. Unit costs of health and social care. Canterbury: Personal Social Services Research Unit, University of Kent and Canterbury, 2002.

    10 Joint Formulary Committee. British National Formulary. 44 ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain; 2002.

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