Changes in medication cost observed in chronic cluster headache patients treated with sphenopalatine ganglion (SPG) stimulation: Analysis based on 1-year data from the Pathway R-1 Registry

Cephalalgia. 2018 Jul;38(8):1455-1462. doi: 10.1177/0333102418784689. Epub 2018 Jun 19.


Background On-demand stimulation of the sphenopalatine ganglion (SPG) by means of an implantable neurostimulation system has been shown to be a safe and effective therapy for treatment-refractory cluster headache patients. Our objective was to estimate changes in cluster headache medication cost observed in SPG-treated chronic patients. Methods Detailed patient-level data of 71 chronic patients treated with the Pulsante® SPG Microstimulator System were available from the Pathway R-1 Registry through 12 months' follow-up. We used utilization data of preventive and acute medications reported at baseline, 3, 6, 9, and 12 months to estimate annualized drug costs for SPG-treated patients and compared it to baseline. Cost estimates for all drug/dosage combinations were developed based on German medication prices for 2016. Results In the base case analysis, mean annual acute and preventive medication costs decreased from €14,178 to €6924 (-€7254; -51%), and €559 to €328 (-€231; -41%), respectively, leading to total estimated annual drug cost savings of €7484, 97% of which were attributable to acute medications. Conclusions Our analysis suggests that SPG stimulation for the treatment of chronic cluster headache is associated with pronounced reductions in cluster headache medication usage that might lead to sizable annual savings in medication costs.

Keywords: Chronic cluster headache; Germany; cost-analysis; implantable stimulator; medication costs; sphenopalatine ganglion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analgesics / economics
  • Analgesics / therapeutic use
  • Cluster Headache / economics*
  • Cluster Headache / therapy*
  • Cost-Benefit Analysis
  • Drug Costs / statistics & numerical data*
  • Electric Stimulation Therapy / economics*
  • Electric Stimulation Therapy / methods*
  • Female
  • Humans
  • Implantable Neurostimulators
  • Male
  • Middle Aged
  • Registries


  • Analgesics