Botox

A draft guidance from NICE has approved Botox as a treatment for patients with migraine. It is to be considered as a treatment for migraine when other treatments have failed. This means that if the draft guidance is approved, then Botox will be available in NHS specialist migraine clinics. Currently it is only available privately; patients pay around £600 a time for private treatment.

Although this sounds a rather “glamorous” treatment for migraine, it actually involves around 35 injections in various sites around the forehead, head and neck. However, many patients have benefited greatly from Botox – for some patients Botox has been life-changing.

The Migraine Trust has welcomed this decision by NICE. NICE estimated the cost to the NHS would be £349.40 for every 12-week cycle of treatment. Although this is expensive, it is likely to be cost effective as patients successively treated will be able to return to work.

Following this announcement, I am almost expecting some of my patients coming with “migraine” symptoms asking whether they could be referred for treatment! This NICE guidance clearly states that patients can be considered for Botox if they have chronic migraine that has not responded to three other types of medication. Patients with chronic migraine have headaches on 15 or more days per month for at least three months and have migraine on at least eight of these days.

With these criteria, I think that hardly any of my patients with migraines will be referred for Botox. It is clearly likely to greatly improve the quality of life for some people though.