Literature DB >> 15023830

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

David Wonderling1, Andrew J Vickers, Richard Grieve, Rob McCarney.   

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.

Entities:  

Mesh:

Year:  2004        PMID: 15023830      PMCID: PMC381327          DOI: 10.1136/bmj.38033.896505.EB

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  12 in total

1.  Handling uncertainty in economic evaluations of healthcare interventions.

Authors:  A H Briggs; A M Gray
Journal:  BMJ       Date:  1999-09-04

Review 2.  Economic analysis of complementary medicine: a systematic review.

Authors:  A R White; E Ernst
Journal:  Complement Ther Med       Date:  2000-06       Impact factor: 2.446

3.  Analysis, sample size, and power for estimating incremental net health benefit from clinical trial data.

Authors:  A R Willan
Journal:  Control Clin Trials       Date:  2001-06

Review 4.  Acupuncture for idiopathic headache.

Authors:  D Melchart; K Linde; P Fischer; B Berman; A White; A Vickers; G Allais
Journal:  Cochrane Database Syst Rev       Date:  2001

5.  Net health benefits: a new framework for the analysis of uncertainty in cost-effectiveness analysis.

Authors:  A A Stinnett; J Mullahy
Journal:  Med Decis Making       Date:  1998 Apr-Jun       Impact factor: 2.583

Review 6.  Burden of migraine. A review of its socioeconomic impact.

Authors:  G D Solomon; K L Price
Journal:  Pharmacoeconomics       Date:  1997       Impact factor: 4.981

7.  Addition of acupuncture and self-care education in the treatment of patients with severe angina pectoris may be cost beneficial: an open, prospective study.

Authors:  S Ballegaard; A Johannessen; B Karpatschof; J Nyboe
Journal:  J Altern Complement Med       Date:  1999-10       Impact factor: 2.579

8.  Costs, effects and C/E-ratios alongside a clinical trial.

Authors:  B A van Hout; M J Al; G S Gordon; F F Rutten
Journal:  Health Econ       Date:  1994 Sep-Oct       Impact factor: 3.046

9.  Economic evaluation of oral sumatriptan compared with oral caffeine/ergotamine for migraine.

Authors:  K W Evans; J A Boan; J L Evans; A Shuaib
Journal:  Pharmacoeconomics       Date:  1997-11       Impact factor: 4.981

10.  Acupuncture for chronic headache in primary care: large, pragmatic, randomised trial.

Authors:  Andrew J Vickers; Rebecca W Rees; Catherine E Zollman; Rob McCarney; Claire M Smith; Nadia Ellis; Peter Fisher; Robbert Van Haselen
Journal:  BMJ       Date:  2004-03-15
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  36 in total

Review 1.  Cost effectiveness of complementary treatments in the United Kingdom: systematic review.

Authors:  Peter H Canter; Joanna Thompson Coon; Edzard Ernst
Journal:  BMJ       Date:  2005-10-15

2.  A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis.

Authors:  J Ratcliffe; K J Thomas; H MacPherson; J Brazier
Journal:  BMJ       Date:  2006-09-15

3.  Acupuncture in mainstream health care.

Authors:  David Wonderling
Journal:  BMJ       Date:  2006-09-23

4.  Acupuncture for 'frequent attenders' with medically unexplained symptoms: a randomised controlled trial (CACTUS study).

Authors:  Charlotte Paterson; Rod S Taylor; Peter Griffiths; Nicky Britten; Sue Rugg; Jackie Bridges; Bruce McCallum; Gerad Kite
Journal:  Br J Gen Pract       Date:  2011-06       Impact factor: 5.386

5.  Acupuncture for Improving Chronic Back Pain, Osteoarthritis and Headache.

Authors:  Karen J Sherman; Remy R Coeytaux
Journal:  J Clin Outcomes Manag       Date:  2009-05-01

6.  Factors affecting decision-making of patients choosing acupuncture in a public hospital.

Authors:  Andrew Arjun Sayampanathan; Thean Howe Bryan Koh; Keng He Kong; Yin Peng Low
Journal:  Ann Transl Med       Date:  2015-11

7.  Traditional acupuncture for people with medically unexplained symptoms: a longitudinal qualitative study of patients' experiences.

Authors:  Sue Rugg; Charlotte Paterson; Nicky Britten; Jackie Bridges; Peter Griffiths
Journal:  Br J Gen Pract       Date:  2011-06       Impact factor: 5.386

8.  Acupuncture for episodic cluster headache: a trigeminal approach.

Authors:  Simon Hayhoe
Journal:  BMJ Case Rep       Date:  2015-09-10

9.  Escitalopram and duloxetine in major depressive disorder: a pharmacoeconomic comparison using UK cost data.

Authors:  Alan G Wade; José-Luis Fernández; Clément François; Karina Hansen; Natalya Danchenko; Nicolas Despiegel
Journal:  Pharmacoeconomics       Date:  2008       Impact factor: 4.981

Review 10.  Acupuncture for the prevention of tension-type headache.

Authors:  Klaus Linde; Gianni Allais; Benno Brinkhaus; Yutong Fei; Michael Mehring; Byung-Cheul Shin; Andrew Vickers; Adrian R White
Journal:  Cochrane Database Syst Rev       Date:  2016-04-19
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