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

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; $768; €598) than for controls (£217) 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 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.