Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.
OBJECTIVE
To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain.


METHODS
Cost-utility analysis alongside a randomized controlled trial.


METHODS
A total of 105 patients with chronic low back pain.


METHODS
Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups.


RESULTS
Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros.


CONCLUSIONS
Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.
Henchoz
Yves
Y
Institute of Sport Sciences of the University of Lausanne, Lausanne, Switzerland. yves.henchoz@unil.ch
Pinget
Christophe
C
Wasserfallen
Jean-Blaise
JB
Paillex
Roland
R
de Goumoëns
Pierre
P
Norberg
Michael
M
Kai-Lik So
Alexander
A
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy / Q000191:economics* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome; D055815:Young Adult