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Table 5 Assumptions adopted when calculating the health effects

From: Structured headache services as the solution to the ill-health burden of headache. 2. Modelling effectiveness and cost-effectiveness of implementation in Europe: methodology

Efficacy

 Efficacy of medications, migraine

ASA 1 g = 0.39 [30]

Sumatriptan 50 mg = 0.35 [22]

Amitriptyline 100 mg daily = 0.44 [23]

 Efficacy of medications, TTH

ASA 1 g = 0.75 (expert opinion)

Paracetamol 1 g = 0.59 [31]

Amitriptyline 100 mg daily = 0.3 (expert opinion)

 Efficacy of withdrawal, MOH

Efficacy = reverted to migraine 85%*2/3 + reverted to TTH 85%*1/3 + unchanged but off medications 15% (expert opinion)

Uptake

 Uptake of medications, migraine

ASA 1 g = 0.635 (expert opinion)

Sumatriptan 50 mg = 0.005 (expert opinion)

Amitriptyline 100 mg = 0.007 (expert opinion)

 Uptake of medications, TTH

Analgesic ASA 1 g = 0.1 (expert opinion)

Paracetamol 1 g = 0.456 (expert opinion)

Amitriptyline 100 mg = 0 (expert opinion)

Treatment efficacy (weighted by medications uptake)

Efficacy*uptake calculations

One medication = [proportion with effect] * [effect] * [uptake];

Combination of two medications = [(proportion with effect)medication A * (effect)medication A * (uptake)medication A] + [(proportion with effect)medication B * (effect)medication B * (uptake)medication B]

Healthy life years (HLYs)

HLYs untreated = DW * proportion of time with headache (= number/year * duration in years);

HLYs treated = HLYs untreated - HLY gained from treatment;

HLYs gained = HLYs untreated * efficacy;

Total HLYs gained per person = sum of (gains from each treatment * probability of having each treatment)

HLYs gained across the population = HLY gained per person affected * prevalence.

HLYs MOH treated = unchanged in 15% + migraine treated HLYs in 2/3*42.5% + TTH treated HLYs in 1/3*42.5%.

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The Journal of Headache and Pain

ISSN: 1129-2377

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