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