scholarly journals Response to the Article “Comparison of the Cost-Utility Analysis of Electroacupuncture and Nonsteroidal Antiinflammatory Drugs in the Treatment of Chronic Low Back Pain”

2019 ◽  
Vol 12 (1) ◽  
pp. 1-2
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Low Back ◽  
Utility Analysis ◽  
Antiinflammatory Drugs ◽  
The Cost

scholarly journals PND43 Cost-Utility Analysis Patients With Low Back Pain After Treatment Intraosseous Blockades

2012 ◽  
Vol 15 (7) ◽  
pp. A553
Author(s):  
M.V. Yakovlev ◽  
A.U. Kulikov ◽  
E.L. Sokov ◽  
L.E. Kornilova
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Low Back ◽  
Utility Analysis

scholarly journals Cost–utility analysis of antibiotic treatment in patients with chronic low back pain and Modic changes: results from a randomised, placebo-controlled trial in Norway (the AIM study)

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035461 ◽  
Author(s):  
Margreth Grotle ◽  
Lars Christian Bråten ◽  
Jens Ivar Brox ◽  
Ansgar Espeland ◽  
Zinajda Zolic-Karlsson ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Antibiotic Treatment ◽  
Chronic Low Back Pain ◽  
Cost Effective ◽  
Cost Utility ◽  
Modic Changes ◽  
Type I ◽  
Low Back ◽  
Utility Analysis

ObjectiveTo evaluate the cost–utility of 100 days of antibiotics in patients with chronic low back pain (LBP) and type I or II Modic changes included in the Antibiotic treatment In patients with chronic low back pain and Modic changes (AIM) study.DesignA cost–utility analysis from a societal and healthcare perspective alongside a double-blinded, parallel group, placebo, multicentre trial.SettingHospital outpatient clinics at six hospitals in Norway. The main results from the AIM study showed a small effect in back-related disability in favour of the antibiotics group, and slightly larger in those with type I Modic changes, but this effect was below the pre-defined threshold for clinically relevant effect.Participants180 patients with chronic LBP, previous disc herniation and Modic changes type I (n=118) or type II (n=62) were randomised to antibiotic treatment (n=89) or placebo-control (n=91).InterventionsOral treatment with either 750 mg amoxicillin or placebo three times daily for 100 days.Main outcome measuresQuality-adjusted life years (QALYs) by EuroQoL-5D over 12 months and costs for healthcare and productivity loss measured in Euro (€1=NOK 10), in the intention-to-treat population. Cost–utility was expressed in incremental cost-effectiveness ratio (ICER).ResultsMean (SD) total cost was €21 046 (20 105) in the amoxicillin group and €19 076 (19 356) in the placebo group, mean difference €1970 (95% CI; −3835 to 7774). Cost per QALY gained was €24 625. In those with type I Modic changes, the amoxicillin group had higher healthcare consumption than the placebo group, resulting in €39 425 per QALY gained. Given these ICERs and a willingness-to-pay threshold of €27 500 (NOK 275 000), the probability of amoxicillin being cost-effective was 51%. Even when the willingness-to-pay threshold increased to €55 000, the probability of amoxicillin being cost-effective was never higher than 53%.ConclusionsAmoxicillin treatment showed no evidence of being cost-effective for people with chronic LBP and Modic changes during 1-year follow-up.Trial registration numberClinicalTrials.gov NCT02323412.

scholarly journals Cost Utility Analysis of Lumbar Interlaminar Epidural Injections in the Treatment of Lumbar Disc Herniation, Central Spinal Stenosis, and Axial or Discogenic Low Back Pain

2017 ◽  
Vol 4 (20;4) ◽  
pp. 219-228 ◽  
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Spinal Stenosis ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Low Back ◽  
Utility Analysis ◽  
Epidural Injections

Background: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting. Objectives: To assess the cost utility of lumbar interlaminar epidural injections in managing chronic low back and/or lower extremity pain secondary to lumbar disc herniation, spinal stenosis, and axial or discogenic low back pain. Study Design: Analysis based on 3 previously published randomized trials of effectiveness of lumbar interlaminar epidural injections assessing their role in disc herniation, spinal stenosis, and axial or discogenic pain. Setting: A contemporary, private, specialty referral interventional pain management center in the United States. Methods: Cost utility of lumbar interlaminar epidural injections with or without steroids in managing lumbar disc herniation, central spinal stenosis, and discogenic or axial low back pain was conducted with data derived from 3 RCTs that included a 2-year follow-up, with inclusion of 360 patients. The primary outcome was significant improvement defined as at least a 50% in pain reduction and disability status. Direct payment data from 2016 was utilized for assessment of procedural costs. Overall costs, including drug costs, were determined by multiplication of direct procedural payment data by a factor of 1.67 to accommodate for indirect payments respectively for disc herniation, spinal stenosis, discogenic pain. Results: The results of 3 RCTs showed direct cost utility for one year of quality-adjusted life year (QALY) of $2,050.87 for disc herniation, $2,112.25 for axial or discogenic pain without disc herniation, and $1,773.28 for spinal stenosis, with an average cost per one year QALY of $1,976.58, with total estimated costs of $3,425, $3,527, $2,961, and $3,301 respectively. Limitations: The limitation of this cost utility analysis includes that it is a single center evaluation, even though 360 patients were included in this analysis. Further, only the costs of interventional procedures and physician visits were assessed based on the data, with extrapolation of indirect costs presenting the overall total costs. The benefits of returning to work were not assessed. Conclusion: This cost utility analysis of lumbar interlaminar epidural injections in patients nonresponsive to conservative management in the treatment of disc herniation, central spinal stenosis, and axial or discogenic low back pain in the lumbar spine shows the clinical effectiveness and cost utility of these injections of $1,976.58 for direct costs with a total cost of $3,301 per QALY.Key words: Lumbar interlaminar epidural injections, chronic low back pain, lumbar disc herniation, lumbar discogenic pain, cost utility analysis, cost effectiveness analysis, qualityadjusted life years

scholarly journals Different doses of Pilates-based exercise therapy for chronic low back pain: a randomised controlled trial with economic evaluation

2018 ◽  
Vol 52 (13) ◽  
pp. 859-868 ◽  
Author(s):  
Gisela Cristiane Miyamoto ◽  
Katherinne Ferro Moura Franco ◽  
Johanna M van Dongen ◽  
Yuri Rafael dos Santos Franco ◽  
Naiane Teixeira Bastos de Oliveira ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Economic Evaluation ◽  
Controlled Trial ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Low Back ◽  
Utility Analysis ◽  
Randomised Controlled ◽  
The Cost ◽  
Different Doses

ObjectivesTo evaluate the effectiveness and cost-utility of the addition of different doses of Pilates to an advice for non-specific chronic low back pain (NSCLBP) from a societal perspective.DesignRandomised controlled trial with economic evaluation.SettingPhysiotherapy clinic in São Paulo, Brazil.Participants296 patients with NSCLBP.InterventionsAll patients received advice and were randomly allocated to four groups (n=74 per group): booklet group (BG), Pilates once a week (Pilates group 1, PG1), Pilates twice a week (Pilates group 2, PG2) and Pilates three times a week (Pilates group 3, PG3).Main outcome measuresPrimary outcomes were pain and disability at 6-week follow-up.ResultsCompared with the BG, all Pilates groups showed significant improvements in pain (PG1, mean difference (MD)=−1.2, 95% CI −2.2 to −0.3; PG2, MD=−2.3, 95% CI −3.2 to −1.4; PG3, MD=−2.1, 95% CI −3.0 to −1.1) and disability (PG1, MD=−1.9, 95% CI −3.6 to −0.1; PG2, MD=−4.7, 95% CI −6.4 to −3.0; PG3, MD=−3.3, 95% CI −5.0 to −1.6). Among the different doses, PG2 showed significant improvements in comparison with PG1 for pain (MD=−1.1, 95% CI −2.0 to −0.1) and disability (MD=−2.8, 95% CI −4.5 to −1.1). The cost-utility analysis showed that PG3 had a 0.78 probability of being cost-effective at a willingness-to-pay of £20 000 per quality-adjusted life-year gained.ConclusionsAdding two sessions of Pilates exercises to advice provided better outcomes in pain and disability than advice alone for patients with NSCLBP; non-specific elements such as greater attention or expectation might be part of this effect. The cost-utility analysis showed that Pilates three times a week was the preferred option.Trial registration numberNCT02241538, Completed.

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