NICE recommendation and NHS reimbursement
On December 3rd 2019, the National Institute for Health and Care Excellence (NICE) published a Medical Technologies Guidance document titled, ‘gammaCore for Cluster Headache’. In the document NICE recommends the use of gammaCore within the NHS for both the acute and preventive treatment of cluster headache in adults. The full guidance document, along with additional resources, can be found here https://www.nice.org.uk/guidance/mtg46. Whilst the guidance recommends that NHS staff utilise gammaCore for patients with cluster headache, this does not automatically mean that the NHS has to fund the treatment.
However:
In April 2019, NHS England agreed to pay for gammaCore, for patients living in England suffering with treatment-refractory cluster headache, as diagnosed by a headache specialist, once they are confirmed as being a responder to therapy.
In Scotland, gammaCore can be accessed through the headache specialists in Glasgow and Aberdeen. Currently, selected NHS Scotland health boards have agreed to pay for gammaCore, for patients suffering with treatment-refractory cluster headache, once they are confirmed as being a responder to therapy.
In Wales and Northern Ireland gammaCore is currently only available via private purchase. The manufacturers of gammaCore, electroCore, are working with the relevant healthcare providers to change this situation and make gammaCore available through the NHS in these countries. Updates will be provided as this situation develops.
www.gammacore.co.uk
www.nice.org.uk/guidance/mtg46
Frequently asked questions
Q. Can gammaCore be prescribed by anyone in the NHS?
A. gammaCore must be prescribed by a headache specialist.
Q. How should I use gammaCore?
A. Training in the correct use of gammaCore is strongly advised for all patients starting treatment to ensure correct use and best chance of success. A training video can be found at www.gammacore.co.uk
A. Contact customerserviceuk@electrocore.com for additional support and training.
A. Patients and prescribers are advised that gammaCore can be used as both a preventive and acute therapy for cluster headache.
A. Not all patients will respond to gammaCore therapy. Patients are advised to complete the full 93-day evaluation before discussing whether to continue therapy with their headache specialist.
Q. Does gammaCore hurt?
A. No. Patients experience a mild tingling sensation whilst using gammaCore. If you have any concerns, then please contact customerserviceuk@electrocore.com
Q. How do I obtain refill cards?
A. Please contact your headache team within 14 days of the current course of gammaCore expiring to arrange continuation of therapy.
Q. Where can I find out more information?
https://ouchuk.org
https://www.migrainetrust.org/living-with-migraine/treatments/transcutaneous-vagus-nerve-stimulation/
www.nice.org.uk/guidance/mtg46
https://pathways.nice.org.uk/pathways/headaches#path=view%3A/pathways/headaches/management-of-headaches.xml&content=view-node%3Anodes-cluster-headache
www.gammacore.co.uk
www.electrocore.com
customerserviceuk@electrocore.com
