Chronic headaches such as migraine and tension headaches are responsible for significant direct health care costs and even larger indirect costs because of lost productivity and burdens on patients and families. Acupuncture has been proposed as an alternative treatment for chronic headaches, but the cost effectiveness of this approach has not been determined. Wonderling and colleagues studied more than 400 patients recruited from general practices in England and Wales to determine the efficacy and costs of acupuncture for chronic headache.

Patients who reported at least two headaches per month were assigned randomly to usual care or up to 12 acupuncture treatments over a three-month period. Data were gathered on the type and severity of headaches, as well as demographic information and costs paid by the patient for headache management. Patients completed a standardized measure of health-related quality of life at baseline, and three and 12 months after starting the study.

At baseline, the 136 patients assigned to acupuncture were similar to the 119 patients assigned to usual care in all important variables. Eighteen patients did not attend their acupuncture sessions. The remaining patients had an average of 4.2 hours of acupuncture therapy. Thirty patients assigned to acupuncture and two patients in the control group visited an acupuncturist for additional treatment during the study. Patients assigned to the acupuncture group showed a statistically significant improvement in health over the year and had small but significant reductions in physician visits and use of complementary or alternative medications. The total costs were higher in the acupuncture group because of acupuncture practitioners’ costs. The researchers calculated the additional cost for each quality-adjusted life year (QALY) gained from acupuncture to be just over $16,300.