Abstract

Background

Cluster headache (CH) is the most frequent trigemino-autonomic cephalgia. CH can manifest as episodic (ECH) or chronic cluster headache (CCH) causing significant burden of disease and requiring attack therapy and prophylactic treatment. The few data available on the economic burden of CH come from retrospective studies based on questionnaires, population surveys and medical insurance claims database. Although all these studies showed an important economic burden, they provided different estimates depending on variability of CH awareness and management, healthcare systems, available therapies and use of treatments according to different guidelines.

Methods

This prospective study aimed to quantify the total direct and indirect cost of ECH and CCH over a cluster period, both for the patient and for the National Health System (NHS), using data from subjects who consecutively attended an Italian tertiary headache centre between January 1, 2018 and December 31, 2018.

Results

A total 108 patients (89 ECH, 19 CCH) were included. Mean attack frequency was 2.3 ± 1.4 per day. Mean total cost of a CH bout was €4398 per patient and total cost of CCH was 5.4 times higher than ECH (€13,350 vs. €2487, p <  0.001). Direct costs represented the 72.1% of total cost and were covered for the 94.8% by the NHS. The costs for any item of expense were higher for CCH than for ECH (p <  0.001). Mean indirect costs for a CH bout were €1226 per patient and were higher for CCH compared to ECH (€3.538 vs. €732), but the difference was not significant. Days with reduced productive capacity impacted for the 64.6% of the total indirect costs. The analysis of the impact CH on work showed that 27%% of patients felt that CH had limited their career, 40% had changed their work pattern, 20% had changed their place of employment and 10% had lost a job due to the disease.

Conclusion

Our results provide a valuable estimate of the direct and indirect costs of ECH and CCH in the specific setting of a tertiary headache centre and confirm the high economic impact of CH on both the NHS and patients.

Details

Title
Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre
Author
Negro, Andrea 1   VIAFID ORCID Logo  ; Sciattella Paolo 2 ; Spuntarelli Valerio 3 ; Martelletti Paolo 1 ; Mennini, Francesco Saverio 4 

1  Sapienza University, Department of Clinical and Molecular Medicine, Rome, Italy (GRID:grid.7841.a); Regional Referral Headache Centre, Sant’Andrea Hospital, Rome, Italy (GRID:grid.415230.1) (ISNI:0000 0004 1757 123X) 
2  University of Rome Tor Vergata, Economic Evaluation & HTA (CEIS- EEHTA), Faculty of Economics, Rome, Italy (GRID:grid.6530.0) (ISNI:0000 0001 2300 0941); Sapienza University of Rome, Department of Statistical Sciences, Rome, Italy (GRID:grid.7841.a) 
3  Sapienza University, Department of Clinical and Molecular Medicine, Rome, Italy (GRID:grid.7841.a) 
4  University of Rome Tor Vergata, Economic Evaluation & HTA (CEIS- EEHTA), Faculty of Economics, Rome, Italy (GRID:grid.6530.0) (ISNI:0000 0001 2300 0941); Institute for Leadership & Management in Health, Kingston University London, London, UK (GRID:grid.15538.3a) (ISNI:0000 0001 0536 3773) 
Publication year
2020
Publication date
Dec 2020
Publisher
Springer Nature B.V.
ISSN
11292369
e-ISSN
11292377
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s10194-020-01115-4
ProQuest document ID
2397992948
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.