A German study has assessed the costs and cost-effectiveness of additional acupuncture treatment in patients with headache. The randomised controlled trial of 3182 patients measured quality of life, cost differences between treatment groups, and the incremental cost-effectiveness ratio (ICER) of acupuncture treatment. The ICER was calculated as 11657 euros per QALY (quality-adjusted life year) gained. According to international cost-effectiveness threshold values, this makes acupuncture a cost-effective treatment in patients with primary headache. (Cost-effectiveness of acupuncture treatment in patients with headache. Cephalalgia. 2008 Apr;28(4):334-45).