Cost-utility analysis of a three-month exercise programme vs. routine usual care following multidisciplinary rehabilitation for chronic low back pain
Yves Henchoz, Christophe Pinget, Jean-Blaise Wasserfallen, Roland Paillex, Pierre de Goumoëns, Michael Norberg, Alexander Kai-Lik So
Objective: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain.
Design: Cost-utility analysis alongside a randomized controlled trial.
Subjects/patients: 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.
Conclusion: 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.
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