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Table 2 Model input parameters

From: Cost-effectiveness of stimulation of the sphenopalatine ganglion (SPG) for the treatment of chronic cluster headache: a model-based analysis based on the Pathway CH-1 study

Variable

Base case

Range

Source

Cohort characteristics

   

Age

45

 

Pathway CH-1 data [8]

Male gender

84 %

 

Clinical effectiveness

Base case

Range (%)

Source

Baseline CH attacks per day

2.74

±50

Pathway CH-1 data [8]

Pain relief with SPG stimulation (within 15 min)

67.1 %

50.2–80.5

Frequency reduction with SPG stimulation (total cohort)

31.0 %

15–50 (assumption)

Absolute decline in frequency reduction for SPG stimulation, per year

3.1 %

0–6.2

Author estimate

Medication costs a

Base case (€)

Range (%)

Source

Oxygen [2.6 * inhalation]

257.20

 

Utilization data based on [7], frequency-adjusted to Pathway CH-1 cohort; 2014 unit cost data from [14]

Zolmitriptan nasal spray [1.08 * 5 mg]

1,118.08

 

Sumatriptan s.c. [1.30 * 6 mg]

2,959.64

 

Sumatriptan nasal spray [1.08 * 20 mg]

112.62

 

Resulting mean medication cost per attack

8.92

±25

SPG stimulation costs

Base case (€)

Range

Source

Implantation of SPG stimulation system (hospital inpatient)

5,293.99

 

DRG B17-B, based on ICD-10-GM diagnosis code G.44 and OPS procedure code 5–059.c2

Reimbursed cost of ATI SPG Neurostimulator

25,000.00

 

Estimate provided by manufacturer

CT/CVT imaging cost pre- and post-implant

400.00

 

Author estimate

6 visits to headache center for device titration, follow-up to implantation

596.46

 

Based on cost reported in [7], adjusted to 2014

Revision of implant (4 of 32 patients)

5,293.99

 

DRG B17-B, based on ICD-10-GM diagnosis code G.44 and OPS procedure code 5–059.c2; implant provided by manufacturer (ATI) at no additional cost [26].

Antibiotics for infection treatment (3 of 32 patients)

94.88

 

Augmentan (amoxicillin) tablets N2 [14]

Device explantation, without new implantation (2 of 32 patients, outpatient)

355.77

 

Ambulatory surgery reimbursement, EBM 31,251, 31,504, 31,670, based on OPC code 5–028.6 [27]

Utilities b

Base case

Range

Source

Baseline

0.55

 

Approximation based on Pathway CH-1 SF-36v2 data and mapping algorithm [15]; years 2–5 extrapolated

End of experimental phase (stimulation)

0.67

 

Open label (stimulation)

0.68

 

12 months (stimulation)

0.61

 

Years 2–5 estimate (stimulation)

0.61

 
  1. a. 6 months, average total costs per patient, medical management cohort; [mean daily intake in patients taking respective medication]
  2. b. mapped EQ-5D scores, based on trial-reported SF-36