title: Cost-effectiveness of naturopathic care for chronic low back pain.
abstract: 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.
authors.affiliation: Department of Psychology, University of Arizona, Tucson, Arizona, USA.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Herman
authors.forename: Orest
authors.initials: O
authors.lastname: Szczurko
authors.forename: Kieran
authors.initials: K
authors.lastname: Cooley
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mills
mesh_terms: 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