Structured headache services as the solution to the ill-health burden of headache. 3. Modelling effectiveness and cost-effectiveness of implementation in Europe: findings and conclusions

Autor: Elena Ruiz de la Torre, Matilde Leonardi, Dimos D. Mitsikostas, Michela Tinelli, Koen Paemeleire, Alberto Raggi, Timothy J. Steiner
Rok vydání: 2021
Předmět:
Quality management
Cost estimate
Cost effectiveness
IMPACT
Cost-Benefit Analysis
Psychological intervention
Healthy Life Years
Tension-type-headache (TTH)
Medicine and Health Sciences
Medicine
health care economics and organizations
Headache
General Medicine
European Brain Council Value of Treatment Headache Working Group
the European Headache Federation
the European Migraine and Headache Alliance and Lifting The Burden: the Global Campaign against Headache
PREVALENCE
Europe
Health
Life Sciences & Biomedicine
Research Article
DISORDERS
Headache Disorders
Clinical Neurology
Humans
Quality improvement
RUSSIA
Migraine
Healthy-life-years
0604 Genetics
Actuarial science
Health economics
Science & Technology
Neurology & Neurosurgery
business.industry
Tension-Type Headache
Neurosciences
Healthy-life-years (HLYs)
1103 Clinical Sciences
economics
Medication-overuse-headache (MOH)
medicine.disease
Anesthesiology and Pain Medicine
Global campaign against headache
Economic evaluation
Structured headache services
RA Public aspects of medicine
Cost-effectiveness
Neurology (clinical)
Neurosciences & Neurology
business
(HLYs)
Zdroj: The Journal of Headache and Pain
The Journal of Headache and Pain, Vol 22, Iss 1, Pp 1-7 (2021)
JOURNAL OF HEADACHE AND PAIN
ISSN: 1129-2377
1129-2369
Popis: BackgroundThere have been several calls for estimations of costs and consequences of headache interventions to inform European public-health policies. In a previous paper, in the absence of universally accepted methodology, we developed headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Here we apply this methodology and present the findings.MethodsData sources were published evidence and expert opinions, including those from an earlier economic evaluation framework using the WHO-CHOICE model. We used three headache-type-specific analytical models, for migraine, tension-type-headache (TTH) and medication-overuse-headache (MOH). We considered three European Region case studies, from Luxembourg, Russia and Spain to include a range of health-care systems, comparing current (suboptimal) care versus target care (structured services implemented, with provider-training and consumer-education). We made annual and 5-year cost estimates from health-care provider and societal perspectives (2020 figures, euros). We expressed effectiveness as healthy life years (HLYs) gained, and cost-effectiveness as incremental cost-effectiveness-ratios (ICERs; cost to be invested/HLY gained). We applied WHO thresholds for cost-effectiveness.ResultsThe models demonstrated increased effectiveness, and cost-effectiveness (migraine) or cost saving (TTH, MOH) from the provider perspective over one and 5 years and consistently across the health-care systems and settings. From the societal perspective, we found structured headache services would be economically successful, not only delivering increased effectiveness but also cost saving across headache types and over time. The predicted magnitude of cost saving correlated positively with country wage levels. Lost productivity had a major impact on these estimates, but sensitivity analyses showed the intervention remained cost-effective across all models when we assumed that remedying disability would recover only 20% of lost productivity.ConclusionsThis is the first study to propose a health-care solution for headache, in the form of structured headache services, and evaluate it economically in multiple settings. Despite numerous challenges, we demonstrated that economic evaluation of headache services, in terms of outcomes and costs, is feasible as well as necessary. Furthermore, it is strongly supportive of the proposed intervention, while its framework is general enough to be easily adapted and implemented across Europe.
Databáze: OpenAIRE
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