Cost-effectiveness of stimulation of the sphenopalatine ganglion (SPG) for the treatment of chronic cluster headache: a model-based analysis based on the Pathway CH-1 study

The Journal of Headache and Pain

Research Article

Arne May¹  Charly Gaul²  Abigail Garner³  Jan B. Pietzsch³ 

[1] Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, Haus S10, Zi. 318, 20246, Hamburg, Germany;Migräne- und Kopfschmerzklinik Königstein, Königstein im Taunus, Germany;Wing Tech Inc., Menlo Park, CA, USA;

关键词: Chronic cluster headache;    Implantable stimulator;    Stimulation;    Sphenopalatine ganglion;    Cost-effectiveness;    Germany;   

DOI  :  10.1186/s10194-015-0530-8

 received in 2015-02-17, accepted in 2015-05-05,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsClinical 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.ResultsSPG 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.ConclusionsOur 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.

【 授权许可】

Unknown   
© Pietzsch et al.; licensee Springer. 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.