Betahistine and cinnarizine for the treatment of Meniere’s disease, vertigo and tinnitus in Switzerland

Commissioned by the Federal Office of Public Health (FOPH) in Switzerland, iMTA performed an HTA-study on betahastine or cinnarizine (with or without dimenhydrinate) for the treatment of Meniere’s disease/syndrome and symptoms of vestibular vertigo and/or tinnitus.
The objective of the study was to evaluate the clinical, economic and other consequences of these treatments compared to the standard of care in Switzerland. For this purpose, several systematic reviews were conducted, on clinical, health economic and other HTA domains. Also, a health economic model was developed for the Swiss situation to specifically evaluate the cost-effectiveness of cinnarizine with dimenhydrinate for the treatment of vertigo caused by other vestibular disorders than Meniere’s disease. The study protocol and HTA report were subject to extensive review of expert reviewers and relevant stakeholders.
The HTA report concluded that the evidence is limited in these populations. Treatment with betahistine may show little or no difference on vertigo and tinnitus compared to placebo. The effects of cinnarizine on tinnitus are very uncertain. Treatment with cinnarizine with dimenhydrinate probably results in an improvement in vertigo caused by other vestibular disorders than Meniere’s disease and leads to projected savings for the Swiss healthcare system.
The full report can be found on the FOPH website.