Osteopathic care for low back pain and neck pain: a cost-utility analysis
Verhaeghe N 1, Schepers J 1-2, van Dun PLS 3, Annemans L 1
Background Low back and neck pain are frequent health problems and osteopathy is a common treatment option for such complaints. The aim was to examine the health and economic consequences of osteopathic care for low back pain and neck pain compared to usual care.
Methods A decision tree model considering a one-year time horizon was applied. The analysis occurred from a health insurance perspective only considering direct medical costs. The health effects were expressed as quality-adjusted life years (QALYs) and the results were expressed in the form of an incremental cost-effectiveness ratio (ICER). The uncertainty around input parameters was addressed applying scenario analyses and one-way sensitivity analyses.
Results In the base case, osteopathy was found to be a cost saving strategy compared to usual care (€300.2 vs. €379.8) at improved QALYs (0.664 vs. 0.633). For neck pain, osteopathy led to additional costs (€648.0 vs. €528.1) and improved QALYs (0.636 vs. 0.608) compared to usual care resulting in a cost-effective strategy (ICER: €4,289/QALY). The findings of the scenario analyses confirmed the promising results from the base case analysis. The one-way sensitivity analysis identified the osteopathic care costs, hospitalization costs and the probability of hospitalization as the major cost drivers.
Conclusion For neck pain, osteopathic care was found to be a cost-effective strategy, while for low back pain osteopathy was even found to be cost saving compared to usual care. Further health economic evaluations of osteopathy for spinal complaints, ideally using data from an accompanying randomized clinical trial, are required.
1 - Department of Public Health, Interuniversity Centre for Health Economics Research (I-CHER), Ghent University, Belgium
2 - Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium
3 - Commission for Osteopathic Research, Practice and Promotion vzw (CORPP), National Centre of COME Collaboration, Mechelen, Belgium