Structured headache services as the solution to the ill-health burden of
headache. 2. Modelling effectiveness and cost-effectiveness of
implementation in Europe: methodology
Background Health economic evaluations support health-care
decision-making by providing information on the costs and consequences
of health interventions. No universally accepted methodology exists for
modelling effectiveness and cost-effectiveness of interventions designed
to close treatment gaps for headache disorders in countries of Europe
(or elsewhere). Our aim here, within the European Brain Council's
Value-of-Treatment project, was to develop headache-type-specific
analytical models to be applied to implementation of structured headache
services in Europe as the health-care solution to headache. Methods We
developed three headache-type-specific decision-analytical models using
the WHO-CHOICE framework and adapted these for three European Region
country settings (Luxembourg, Russia and Spain), diverse in geographical
location, population size, income level and health-care systems and for
which we had population-based data. Each model compared current
(suboptimal) care vs target care (delivered in accordance with the
structured headache services model). Epidemiological and economic data
were drawn from studies conducted by the Global Campaign against
Headache; data on efficacy of treatments were taken from published
randomized controlled trials; assumptions on uptake of treatments, and
those made for Healthy Life Year (HLY) calculations and target-care
benefits, were agreed with experts. We made annual and 5-year cost
estimates from health-care provider (main analyses) and societal
(secondary analyses) perspectives (2020 figures, euros). Results The
analytical models were successfully developed and applied to each
country setting. Headache-related costs (including use of health-care
resources and lost productivity) and health outcomes (HLYs) were mapped
across populations. The same calculations were repeated for each
alternative (current vs target care). Analyses of the differences in
costs and health outcomes between alternatives and the incremental
cost-effectiveness ratios are presented elsewhere. Conclusions This
study presents the first headache-type-specific analytical models to
evaluate effectiveness and cost-effectiveness of implementing structured
headache services in countries in the European Region. The models are
robust, and can assist policy makers in allocating health budgets
between interventions to maximize the health of populations