[Treatment costs of otogenic vertigo]. / Die Kosten der Behandlung des otogenen Schwindels. Therapie mit einem Kombinationspräparat (Cinnarizin 20 mg und Dimenhydrinat 40 mg) im Vergleich zur Therapie mit Betahistin (12 mg).

PURPOSE: In this decision-tree analysis, the costs of otogenic vertigo treatment were investigated from the third-party payer's perspective. Either the combination preparation, with cinnarizine 20 mg and dimenhydrinate 40 mg as active substances, or betahistine (12 mg betahistinedimesilate) was administered. METHODS: A core model, based on clinical studies, was developed and a cost-effectiveness analysis was conducted. Both differences in effectiveness of the alternative treatments and adverse reactions and side effects were included. The number of cases, in which no more symptoms of dizziness were detected after 4 weeks of therapy, served as the effectiveness parameter. RESULTS: The effectiveness-adjusted costs amounted to 130.11 Euros for patients treated with the combination preparation and 629.28 Euros for treatment with betahistine. CONCLUSION: From the third-party payer's perspective, therapy of otogenic vertigo with the combination preparation is more cost-effective than a treatment with betahistine. From the patient's perspective, the higher effectiveness and the superior profile of side effects militate in favor of a therapy with the combination preparation.

Treatment of vertigo with a homeopathic complex remedy compared with usual treatments: a meta-analysis of clinical trials.

The increasing interest in alternative medical practices has led to a number of controlled studies on herbal and homeopathic agents. This paper presents the results of a meta-analysis of four recent clinical trials evaluating the homeopathic preparation Vertigoheel (VH) compared with usual therapies (betahistine, Ginkgo biloba extract, dimenhydrinate) for vertigo in a total of 1388 patients. Two trials were observational studies and the other two were randomised double-blind controlled trials. The duration of treatment (6-8 weeks) and dosage were comparable in all studies. Treatments were evaluated for the variables "number of vertigo episodes", "intensity of episodes" and "duration of episodes". As the studies differed in the age of patients and in the baseline values of vertigo, the individual reductions of number, intensity and duration of episodes were adjusted on equal age and baseline values (total means). An analysis of variance (with studies as random effects) showed no relevant influence of studies on the adjusted reductions and no relevant interaction between studies and treatment effects. The meta-analysis of all four trials showed equivalent reductions with VH and with control treatment: mean reduction of the number of daily episodes 4.0 for VH and 3.9 for control (standard error 0.11 for both groups); mean reduction of the duration (on a scale 0-4) for VH 1.1 and for the control 1.0 (standard error 0.03 for both groups); mean reduction of the intensity (on a scale 0-4) for VH 1.18 and for the control 1.8 (standard error 0.03 for both groups). In the non-inferiority analysis from all trials, VH was non-inferior in all variables. The results show the applicability of meta-analyses on the data from studies with homeopathicdrugs and support the results from the individual studies indicating good efficacy and tolerability of VH in patients with vertigo.