Wu Elizabeth C, Hancock-Howard Rebecca, Chan Brian C F, Coyte Peter C
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Medicine (Baltimore). 2025 May 2;104(18):e42304. doi: 10.1097/MD.0000000000042304.
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.
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%.
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.
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.
针灸在中国已被用于缓解疼痛数千年，可能是预防偏头痛的药物预防的一种替代方法。最近，出现了关于针灸预防偏头痛的有前景的临床数据。然而，在台湾，很少有研究调查针灸对偏头痛预防的经济影响。
本研究旨在从台湾医疗保健支付者和社会角度评估针灸在预防偏头痛方面的终生经济影响。构建了一项经济成本效益评估，以比较针灸与药物预防以及台湾发作性偏头痛和慢性偏头痛患者终生不进行积极治疗的情况。流行病学和临床数据来自已发表的文献。医疗保健成本和利用率基于对国民健康保险研究数据库的回顾性纵向分析。生产力损失来自一项劳动经济学研究。健康收益按全国平均收入的3倍估值。所有成本均使用台湾的消费者价格指数调整为2023新台币，并以3%的贴现率报告为现值。
从卫生系统和社会角度来看，针灸治疗与不进行积极治疗相比，终生净经济收益显著更多（分别为1,248,464新台币和1,321,994新台币）。同样，与药物预防相比，针灸也有终生净经济收益：分别为909,571新台币（卫生系统）和963,510新台币（社会）。针灸的经济收益来自于因偏头痛天数减少而降低生产力损失带来的成本节约以及质量调整生命年增加带来的价值提升。终生经济收益在年轻、女性和慢性偏头痛患者中最大。
与不进行积极治疗或药物预防相比，针灸在预防偏头痛方面具有更大的终生净经济收益。台湾的决策者应考虑增加针灸治疗的报销额度，以鼓励其使用。
