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Introduction <p>Pharmacopuncture, which combines traditional acupuncture with herbal medicine, may offer synergic therapeutic effects for insomnia management; however, evidence on its economic value remains limited. This study evaluates the cost-effectiveness of pharmacopuncture for insomnia disorder compared with other acupuncture modalities in South Korea.</p> Methods <p>Two Markov models were developed from a healthcare system perspective to assess the short- and long-term cost-effectiveness of pharmacopuncture. The models included four levels of insomnia severity based on the Insomnia Severity Index (ISI). Transition probabilities, medical costs, and utility weights were derived from a pragmatic randomized controlled trial (KCT0006803). A 4-week cycle length was applied to stimulate 100 participants with moderate-to-severe insomnia. The short- and long-term models employed 8- and 24-week time horizons, respectively. Effective outcomes included the proportion of remission (ISI &lt; 8) and quality-adjusted life-years (QALYs).</p> Results <p>Pharmacopuncture incurred an incremental cost of KRW 368,000 (USD 270) per additional remission achieved over 8 weeks. Long-term analysis showed an incremental cost-effectiveness ratio of KRW 16,940,000 (USD 12,600) per QALY. Sensitivity analyses revealed that cost-effectiveness was sensitive to pharmacopuncture pricing.</p> Conclusion <p>Pharmacopuncture can be considered cost-effective if decision-makers accept an additional cost of KRW 400,000 (approximately USD 280) per responder over 2&#xa0;months. At a willingness-to-pay threshold of KRW 27,660,000 (approximately USD 21,740), pharmacopuncture is a cost-effective option for managing insomnia compared with other acupuncture modalities.</p>

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Cost-Effectiveness of Pharmacopuncture Versus Conventional Acupuncture for Insomnia: An RCT-Based Economic Evaluation with a Markov Model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月10日

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  • Eun Cho,
  • Ji-Eun Lee,
  • Jung-Hwa Lim,
  • Jae-Hyok Lee,
  • Chan-Young Kwon,
  • Bo-Kyung Kim

摘要

Introduction

Pharmacopuncture, which combines traditional acupuncture with herbal medicine, may offer synergic therapeutic effects for insomnia management; however, evidence on its economic value remains limited. This study evaluates the cost-effectiveness of pharmacopuncture for insomnia disorder compared with other acupuncture modalities in South Korea.

Methods

Two Markov models were developed from a healthcare system perspective to assess the short- and long-term cost-effectiveness of pharmacopuncture. The models included four levels of insomnia severity based on the Insomnia Severity Index (ISI). Transition probabilities, medical costs, and utility weights were derived from a pragmatic randomized controlled trial (KCT0006803). A 4-week cycle length was applied to stimulate 100 participants with moderate-to-severe insomnia. The short- and long-term models employed 8- and 24-week time horizons, respectively. Effective outcomes included the proportion of remission (ISI < 8) and quality-adjusted life-years (QALYs).

Results

Pharmacopuncture incurred an incremental cost of KRW 368,000 (USD 270) per additional remission achieved over 8 weeks. Long-term analysis showed an incremental cost-effectiveness ratio of KRW 16,940,000 (USD 12,600) per QALY. Sensitivity analyses revealed that cost-effectiveness was sensitive to pharmacopuncture pricing.

Conclusion

Pharmacopuncture can be considered cost-effective if decision-makers accept an additional cost of KRW 400,000 (approximately USD 280) per responder over 2 months. At a willingness-to-pay threshold of KRW 27,660,000 (approximately USD 21,740), pharmacopuncture is a cost-effective option for managing insomnia compared with other acupuncture modalities.