Cost effectiveness analysis of a randomised trial of acupuncture for chronic headache in primary care.
OBJECTIVE
To evaluate the cost effectiveness of acupuncture in the management of chronic headache.


METHODS
Cost effectiveness analysis of a randomised controlled trial.


METHODS
General practices in England and Wales.


METHODS
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.


METHODS
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.
Wonderling
David
D
Health Services Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT. David.Wonderling@lshtm.ac.uk
Vickers
Andrew J
AJ
Grieve
Richard
R
McCarney
Rob
R
D015670:Acupuncture Therapy / Q000191:economics* / Q000379:methods; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004739:England; D005194:Family Practice / Q000191:economics; D020773:Headache Disorders / Q000191:economics / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011787:Quality of Health Care; D019057:Quality-Adjusted Life Years; D014852:Wales