Summary

Summary

  • The technology described in this briefing is gammaCore. It is used as a daily preventative measure for cluster headache and can be used to treat pain during a headache.

  • The innovative aspects compared with other vagus nerve stimulators is that gammaCore is applied to the surface of the neck rather than surgically implanted.

  • The intended place in therapy would be as well as standard care, most likely where standard treatments for cluster headache are ineffective, not tolerated or contraindicated. It would be prescribed by neurologists who provide specialist headache services.

  • The main points from the evidence summarised in this briefing are from 5 studies: 3 randomised controlled trials, 1 open-label randomised trial and 1 cohort study including a total of 465 people. They show that use of gammaCore alongside standard care may be more effective than standard care only in treating cluster headaches.

  • Key uncertainties around the evidence and technology are that people with episodic and chronic cluster headaches respond differently to treatment with gammaCore. The optimal use of gammaCore in the different populations is unclear.

  • The cost of gammaCore treatment is £625 for 93 days (exclusive of VAT). The resource impact would be more than standard care, except where it replaces current treatments.