Cost-effectiveness of naturopathic care for chronic low back pain.
OBJECTIVE
To determine the cost-effectiveness of naturopathic care (acupuncture, relaxation exercises, exercise and dietary advice, and a back care booklet) compared to standardized physiotherapy education and a back care booklet (control treatment) for low back pain in a sample (N = 70) of warehouse workers.


METHODS
Economic evaluation based upon the results of a pragmatic randomized controlled trial to determine the cost-effectiveness of naturopathic care to society as a whole, to the employer, and to participants.


RESULTS
Naturopathic care (as compared to the control treatment) significantly improved quality-adjusted life-years over the 6-month study period (3-month intervention period and 3-month follow-up period) by 0.0256 (95% CI: 0.0075, 0.0437)--roughly equivalent to 9.4 "perfect health" days. Naturopathic care also significantly reduced societal costs by $1212 per participant. From the perspective of the employer, the intervention cost $154 per absentee day avoided (compared to employer costs of lost productivity of $172 per day) and had a return on investment of 7.9% under the healthcare coverage limits set by this employer and assuming the employer paid the full cost of naturopathic care. Participants experienced savings in adjunctive care of $1096 per participant.


CONCLUSIONS
This economic evaluation alongside a pragmatic randomized control trial shows naturopathic care to be more cost-effective than a standardized physiotherapy education regimen in the treatment of chronic low back pain. Further studies of the economic impact of naturopathic medicine are warranted.
Herman
Patricia M
PM
Department of Psychology, University of Arizona, Tucson, Arizona, USA.
Szczurko
Orest
O
Cooley
Kieran
K
Mills
Edward J
EJ
D015670:Acupuncture Therapy / Q000191:economics; D000328:Adult; D002908:Chronic Disease / Q000191:economics; D003362:Cost-Benefit Analysis; D015444:Exercise; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000191:economics* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009324:Naturopathy / Q000191:economics*; D009784:Occupational Diseases / Q000191:economics* / Q000534:rehabilitation*; D012064:Relaxation Therapy / Q000191:economics; D016896:Treatment Outcome