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Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre
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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197153/ https://www.ncbi.nlm.nih.gov/pubmed/32366217 http://dx.doi.org/10.1186/s10194-020-01115-4 |
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author | Negro, Andrea Sciattella, Paolo Spuntarelli, Valerio Martelletti, Paolo Mennini, Francesco Saverio |
author_facet | Negro, Andrea Sciattella, Paolo Spuntarelli, Valerio Martelletti, Paolo Mennini, Francesco Saverio |
author_sort | Negro, Andrea |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7197153 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-71971532020-05-08 Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre Negro, Andrea Sciattella, Paolo Spuntarelli, Valerio Martelletti, Paolo Mennini, Francesco Saverio J Headache Pain Research Article 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. Springer Milan 2020-05-04 /pmc/articles/PMC7197153/ /pubmed/32366217 http://dx.doi.org/10.1186/s10194-020-01115-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Negro, Andrea Sciattella, Paolo Spuntarelli, Valerio Martelletti, Paolo Mennini, Francesco Saverio Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
title | Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
title_full | Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
title_fullStr | Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
title_full_unstemmed | Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
title_short | Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
title_sort | direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197153/ https://www.ncbi.nlm.nih.gov/pubmed/32366217 http://dx.doi.org/10.1186/s10194-020-01115-4 |
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