Economic impact of acupuncture for the prevention of episodic migraine and chronic migraine in Taiwan.

BACKGROUND

Acupuncture has been used for pain relief for thousands of years in China, and could be an alternative to drug prophylaxis for migraine prevention. Recently, promising clinical data on acupuncture for migraine prevention has emerged. However, few studies have investigated the economic impact of acupuncture on migraine prevention in Taiwan.

METHODS

This study aims to assess the lifetime economic impact of acupuncture in migraine prevention from both a Taiwanese healthcare payer and a societal perspective. An economic cost-benefit evaluation was constructed to compare acupuncture with drug prophylaxis and with no active treatment among patients with episodic migraine and chronic migraine over their lifetime in Taiwan. Epidemiological and clinical inputs were collected from the published literature. Healthcare costs and utilization were based on a retrospective longitudinal analysis of the National Health Insurance Research Database. Productivity loss was derived from a labor economic study. Health gains were valued at 3× average national income. All costs were adjusted to 2023 New Taiwan dollars using the consumer price index in Taiwan and reported as the present value with a discount rate of 3%.

RESULTS

From both health system and societal perspectives, acupuncture treatment was associated with significantly more lifetime net economic gains than no active treatment ($1,248,464 and $1,321,994, respectively). Similarly, there was a net lifetime economic gain when acupuncture was compared to drug prophylaxis: $909,571 (health system) and $963,510 (societal), respectively. The economic gain of acupuncture was driven by cost savings from reducing productivity loss and increased value from quality-adjusted life-year gain from fewer migraine days. Lifetime economic gain was greatest among young, female, and chronic migraine patients.

CONCLUSION

Acupuncture was associated with greater lifetime net economic gains in migraine prevention compared to no active treatment or drug prophylaxis. Decision-makers in Taiwan should consider increasing reimbursements for acupuncture sessions to encourage its utilization.