Four innovations will be fast-tracked into use in the NHS through the Innovation and Technology Payment 2019/20 programme, supported by the AHSN Network. One of these is gammaCore™.

Challenge/problem identified

Cluster headaches are excruciating attacks of pain in one side of the head, often felt around the eye. Cluster headaches (CH) are rare.  Anyone can get them, but they’re more common in men and tend to start when a person is in their 30s or 40s. Around 66,000 people in the UK experience cluster headache.

Current treatments and therapies can be limited by side effects, and the off-label use of medications designed for the treatment of unrelated conditions is common.

Cluster headaches are estimated to cost the NHS in England in excess of £10,000 a year, on average per patient on average.

High-flow oxygen cylinders may be sent to a patient’s home to provide acute pain relief during an attack, but this can be impractical and requires regular re-fills and maintenance.

It is estimated that for 5% of people with cluster headache, standard care will not work or be unsuitable, or for whom standard treatment has been unsuccessful or in people who cannot have other prescribed treatments.

Many patients do not gain adequate control of their condition and as such remain ‘treatment refractory’. These patients may end up being referred for an expensive surgical procedure as their last chance of achieving treatment success.


electroCore™ have developed a device called gammaCore™ which administers vagus nerve stimulation non-invasively by delivering a proprietary signal through the skin to either the right or the left branches of the vagus nerve in the neck.

Stimulating the vagus nerve affects many important autonomic functions in the brain and in the body, including neurotransmitters and inflammation levels.

A large body of clinical evidence supports the use of non-invasive vagus nerve stimulation (nVNS) in the treatment of primary headache conditions including the acute and preventive treatment of cluster headache.

gammaCore™ is a simple-to-use, handheld medical device that enables patients to self-administer discrete doses of nVNS therapy both prophylactically and acutely in the management of their CH. gammaCore works by sending a mild electrical stimulation through the skin to activate the vagus nerve from outside the body.

gammaCore differs from other vagus nerve stimulators in being applied to the skin of the neck rather than implanted by a surgical procedure.

Note: gammaCore can only be prescribed by a specialist in primary or secondary care.


Real world evidence from headache experts shows that in clinical practice, gammaCore is effective in approximately 50% of patients with CH.

Patients who respond typically experience reductions in the frequency, duration and severity of CH attacks, and some may even find the condition is placed into remission.

electroCore currently provides 93 consecutive days of nVNS therapy, at no cost to the NHS. This introductory, patient-by-patient, evaluation identifies positive nVNS responders. Only those patients deemed to be responders will continue onto paid for therapy.

Cost-savings are realised as CH symptoms are reduced and the need for expensive acute rescue medication usage becomes less. There may also be a reduction in the use of general healthcare services, such as outpatient appointments, telephone consultations, GP visits and A&E attendances, as a consequence of an improvement in prophylactic control as the patient is able to better manage their CH symptoms with gammaCore.

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Twitter: @ElectroCoreVNS