Table 1.
Costs and resource use assumptions
| Variable | Individual scenario | Time-derived | Definition | Source |
|---|---|---|---|---|
| Administration costs Botox initial cycle | £513.60 | £70.00 | Spire: Treatment (£650 incl. follow-up visits and drug) + initial adminstration (£140) − drug costs/Time-based: Consultant visit lasts 30 min plus 15 min nurse time | http://www.spirehealthcare.com/hull/news/botox-for-migraine-treatment/. Accessed 14/02/2016, PSSRU, unit costs of health and social care 2014 (Curtis 2014) |
| Administration costs Botox every 12 weeks | £373.60 | £60.00 | Spire Hull: Treatment (£650, incl. follow-up visits and drug) - drug costs/Time-based: Consultant visit lasts 15 min plus 15 min nurse time | http://www.spirehealthcare.com/hull/news/botox-for-migraine-treatment/. Accessed 14/02/2016, PSSRU, unit costs of health and social care 2014 (Curtis 2014), |
| Botox drug costs per 12 weeks cycle | £276.40 | £276.40 | Drug costs | NICE Botox appraisal |
| Botox drug costs for 48 week cycle | £276.40 | £276.40 | Drug costs | NICE Botox appraisal |
| Administration costs TMS in initial quarter | £140.00 | £35.00 | Spire Hull: Initial consultation fee £140/Time-based: Consultant visit lasts 15 min | http://www.spirehealthcare.com/hull/news/botox-for-migraine-treatment/. Accessed 14/02/2016; PSSRU (Curtis 2014), Personal communication Hull |
| Administration costs TMS in follow-up quarter | 0 | 0 | Device used at home by patient | |
| Costs TMS in initial quarter responder | 0 | 0 | Not applied due to risk share approach | Manufacturer |
| Costs TMS in follow-up quarter responder | £450.00 | £450.00 | Current sTMS costs | Manufacturer |
| Costs 1 GP Visit | £45.63 | £45.63 | Surgery consultation last 11.7 min £3.90 per min (with qualification costs) incl. direct staff (Table 10.8b) | PSSRU, unit costs of health and social care 2014 (Curtis 2014) |
| Costs hospital inpatient stay migraine | £514.00 | £514.00 | NHS 2013/14 National Tariff—Patients continuing on Botox and TMS were assumed to be in need for furhter neurologists visits; PA04B applied for dicontinuing | https://www.gov.uk/government/collections/payment-by-results-2013-14. Accessed 14/02/2016 |
| Costs neurologist visit | £128.00 | £128.00 | National tariff information spreadsheet-index: Neurology and Neurosurgery outpatient attendances | https://www.gov.uk/government/collections/payment-by-results-2013-14. Accessed 14/02/2016 |
| Costs emergency department visit | £78.00 | £78.00 | National Tariff—VB09Z | https://www.gov.uk/government/collections/payment-by-results-2013-14. Accessed 14/02/2016 |
| Costs Triptan use per attack | £1.08 | £1.08 | Weighted average for the mean cost of 1 triptan tablet in NHS England 2014 | http://www.hscic.gov.uk/catalogue/PUB17274/pres-cost-anal-eng-2014-rep.pdf and Botox appraisal 2011 |
| Number of A&E events per quarter | 0.51 | 0.51 | UK specific data from IBMS, Table 3 | Bloudek et al. (2012) |
| Number of GP visits for migraine per quarter | 1.44 | 1.44 | UK specific data from IBMS, Table 3 | Bloudek et al. (2012) and Blumenfeld et al. (2011) |
| Number of hospital inpatient stays per quarter | 0.09 | 0.09 | UK specific data from IBMS, Table 3 | Bloudek et al. (2012) |
| Number of neurologists visit per quarter | 0.43 | 0.43 | UK specific data from IBMS, Table 3 | Bloudek et al. (2012) |
| Number of Triptans used per quarter | 7.29 | 7.29 | 7.29 triptans used for patients more than 15 attacks | NICE Botox Appraisal (2011): Table 6.17 page 160 |
| Probability Botox continuation | 45.5 % | 45.5 % | Responder after cycle 2 based on Khalil et al. (2015b) | Khalil et al. (2015b) |
| Probability TMS continuation | 53.7 % | 53.7 % | Discontinuer minus those discontinuing due to lack of funding | Bhola et al. (2015) |
| Botox resource use reduction per responder 12 weeks | 49.7 % | 49.7 % | Observed reduction rate in observational trial | Rothrock (2011), Table 3 |
| TMS resource use reduction per responder quarter | 46.7 % | 46.7 % | Observed reduction rate in observational trial | Bhola et al. (2015), Table 3 |