Cluster headache and migraine are two types of headache disorders. With cluster headache, people experience severe attacks of pain on one side of the head. The attacks happen often and in groups or “clusters.” Migraines are headaches that happen repeatedly and cause moderate to severe pulsating pain, usually on 1 side of the head. Cluster headache and migraine can cause substantial disability and affect people’s quality of life.

Many people with cluster headache or migraine find it difficult to manage their headache pain with standard medications. Others may experience side effects, be unable to take medications, or simply prefer to treat their pain without medications. Noninvasive vagus nerve stimulation (nVNS) is a nondrug, noninvasive treatment option that delivers a mild electrical stimulation to a nerve in the neck. It is intended to reduce the pain of a headache attack, make the attack shorter, or reduce the frequency of the headache attack.

This health technology assessment looked at how safe, effective, and cost-effective nVNS is for the acute treatment and prevention of cluster headache or migraine. It also looked at the budget impact of publicly funding nVNS and at the experiences, preferences, and values of people with cluster headache or migraine.