Witt C M, Reinhold T, Jena S, Brinkhaus B, Willich S N
Institute for Social Medicine, Epidemiology, and Health Economics, Charité, University Medical Centre, Berlin, Germany.
Cephalalgia. 2008 Apr;28(4):334-45. doi: 10.1111/j.1468-2982.2007.01504.x.
The aim was to assess costs and cost-effectiveness of additional acupuncture treatment in patients with headache compared with patients receiving routine care alone. A randomized, controlled trial was conducted, including patients (> or =18 years old) with primary headache (more than 12 months, at least two headaches/month). Outcome parameters were quality of life (Short Form 36), direct and indirect costs differences during the 3-month study period and the incremental cost-effectiveness ratio (ICER) of acupuncture treatment. A total of 3182 patients (1613 acupuncture; 1569 controls) with headache were included (77.4% women, mean age and standard deviation 42.6 +/- 12.3; 22.6% men, 47.2 +/- 13.4). Over 3 months costs were higher in the acupuncture group compared with the control [euro857.47; 95% confidence interval 790.86, 924.07, vs. euro527.34 (459.81, 594.88), P < 0.001, mean difference: euro330.12 (235.27, 424.98)]. This cost increase was primarily due to costs of acupuncture [euro365.64 (362.19, 369.10)]. The ICER was euro11 657 per QALY gained. According to international cost-effectiveness threshold values, acupuncture is a cost-effective treatment in patients with primary headache.
目的是评估与仅接受常规护理的患者相比，额外针灸治疗对头痛患者的成本及成本效益。进行了一项随机对照试验，纳入了原发性头痛（超过12个月，每月至少两次头痛）的患者（≥18岁）。结果参数包括生活质量（简明健康状况调查量表36项）、3个月研究期间的直接和间接成本差异以及针灸治疗的增量成本效益比（ICER）。共纳入3182例头痛患者（1613例接受针灸治疗；1569例为对照组）（女性占77.4%，平均年龄及标准差为42.6±12.3；男性占22.6%，47.2±13.4）。在3个月期间，针灸组的成本高于对照组[857.47欧元；95%置信区间790.86，924.07，而对照组为527.34欧元（459.81，594.88），P<0.001，平均差异：330.12欧元（235.27，424.98）]。成本增加主要归因于针灸费用[365.64欧元（362.19，369.10）]。每获得一个质量调整生命年的ICER为11657欧元。根据国际成本效益阈值，针灸是原发性头痛患者的一种具有成本效益的治疗方法。
