Abstract | BACKGROUND: In the recent Pathway CH-1 study, on-demand stimulation of the sphenopalatine ganglion (SPG) by means of an implantable neurostimulation system was proven to be a safe and effective therapy for the treatment of chronic cluster headache. Our objective was to assess the cost-effectiveness of SPG stimulation in the German healthcare system when compared to medical management. METHODS: Clinical data from the Pathway CH-1 study were used as input for a model-based projection of the cost-effectiveness of SPG stimulation through 5 years. Medical management as the comparator treatment was modeled on the basis of clinical events observed during the baseline period of CH-1. The costs of treatment were derived from a previously published cluster headache costing study and 2014 medication, neurostimulator, and procedure costs. We computed the 5-year incremental cost-effectiveness ratio (ICER) in euros per quality-adjusted life year (QALY), with costs and effects discounted at 3 % per year. RESULTS: SPG stimulation was projected to add 0.325 QALYs over the study period, while adding €889 in cost, resulting in a 5-year ICER of €2,736 per QALY gained. Longer follow-up periods, higher baseline attack frequency, and higher utilization of attack-aborting medications led to overall cost savings. SPG stimulation was found either cost-effective or cost-saving across all scenarios investigated in sensitivity analyses. CONCLUSIONS: Our model-based analysis suggests that SPG stimulation for the treatment of chronic cluster headache, under the assumption of sustained therapy effectiveness, leads to meaningful gains in health-related quality of life and is a cost-effective treatment strategy in the German healthcare system.
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Authors | Jan B Pietzsch, Abigail Garner, Charly Gaul, Arne May |
Journal | The journal of headache and pain
(J Headache Pain)
Vol. 16
Pg. 530
( 2015)
ISSN: 1129-2377 [Electronic] England |
PMID | 26002638
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adult
- Cluster Headache
(therapy)
- Cost-Benefit Analysis
- Electric Stimulation Therapy
(methods)
- Electrodes, Implanted
- Female
- Ganglia, Parasympathetic
- Health Care Costs
- Humans
- Male
- Middle Aged
- Pterygopalatine Fossa
(innervation)
- Quality-Adjusted Life Years
- Treatment Outcome
- Young Adult
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