Abstract
Electroacupuncture (EA) is used to treat pain after back surgery. Although this treatment is covered by national health insurance in Korea, evidence supporting its cost-effectiveness and contribution to the sustainability of the national health care system has yet to be published. Therefore, an economic evaluation, alongside a clinical trial, was conducted to estimate the cost-effectiveness of EA and usual care (UC) versus UC alone to treat non-acute low back pain (LBP). In total, 108 patients were recruited and randomly assigned to treatment groups; 106 were included in the final cost utility analysis. The incremental cost-effectiveness ratio of EA plus UC was estimated as 7,048,602 Korean Rate Won (KRW) per quality-adjusted life years (QALYs) from the societal perspective (SP). If the national threshold was KRW 30 million per QALY, the cost-effectiveness probability of EA plus UC was an estimated 85.9%; and, if the national threshold was over KRW 42,496,372 per QALY, the cost-effectiveness probability would be over 95% percent statistical significance. Based on these results, EA plus UC combination therapy for patients with non-acute LBP may be cost-effective from a societal perspective in Korea.
Highlights
Increasing health care expenditure within the budget constraints caused by an aging population demands the examination of the efficacy and effectiveness of treatment, and the cost-effectiveness of treatment alternatives that support the sustainability of the national health care system [1,2]
There were no significant differences between the groups at baseline for any of the variables except direct medical cost (Table 1)
The deterministic and sensitivity analyses of different perspectives using per protocol (PP) and ITT data showed that the EA and usual care (UC) combination was more effective and costlier than UC alone
Summary
Increasing health care expenditure within the budget constraints caused by an aging population demands the examination of the efficacy and effectiveness of treatment, and the cost-effectiveness of treatment alternatives that support the sustainability of the national health care system [1,2]. This trend impacts the use of therapies in the area of complementary and alternative medicine, which have been commonly employed to treat various diseases, and are already approved for national health insurance reimbursement in Korea [3]. According to a recent review, 37% of guidelines recommended radiofrequency denervation for chronic LBP, while 25% recommended it restrictively only if there was no improvement with conservative treatments [6]
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