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Clinical Trial
. 2004 Mar 27;328(7442):747.
doi: 10.1136/bmj.38033.896505.EB. Epub 2004 Mar 15.

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

David Wonderling  1 , Andrew J Vickers, Richard Grieve, Rob McCarney
Affiliations
Clinical Trial

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

David Wonderling et al. BMJ. .

Abstract

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 (403 pounds sterling; 768 dollars; 598 euros) than for controls (217 pounds sterling) 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 9180 pounds sterling 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.

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Figures

Fig 1
Fig 1
Cost effectiveness acceptability curve with sensitivity analysis for acupuncture unit cost
Fig 2
Fig 2
Cost effectiveness acceptability curve with sensitivity analysis for duration of effect
See this image and copyright information in PMC

References

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    1. 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. - PubMed

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