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A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis

Ratcliffe, J., Thomas, K.J., MacPherson, H. and Brazier, J. (2006) A randomised controlled trial of acupuncture care for persistent low back pain: cost effectiveness analysis. British Medical Journal, 333 (7569). pp. 626-628. ISSN 0959-8138

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Abstract

OBJECTIVE

To evaluate the cost effectiveness of acupuncture in the management of persistent non-specific low back pain.

DESIGN

Cost effectiveness analysis of a randomised controlled trial.

SETTING

Three private acupuncture clinics and 18 general practices in York, England.

PARTICIPANTS

241 adults aged 18-65 with non-specific low back pain of 4-52 weeks' duration.

INTERVENTIONS

Ten individualised acupuncture treatments over three months from acupuncturists trained in traditional Chinese medicine (n = 160) or usual care only (n = 81).

MAIN OUTCOME MEASURE

Incremental cost per quality adjusted life year (QALY) gained over two years.

RESULTS

Total costs to the United Kingdom's health service during the two year study period were higher on average for the acupuncture group (£460; 673; $859) than for the usual care group (£345) because of the costs associated with initial treatment. The mean incremental health gain from acupuncture at 12 months was 0.012 QALYs (95% confidence interval -0.033 to 0.058) and at 24 months was 0.027 QALYs (-0.056 to 0.110), leading to a base case estimate of £4241 per QALY gained. This result was robust to sensitivity analysis. The probabilistic sensitivity analysis showed acupuncture to have a more than 90% chance of being cost effective at a £20 000 cost per QALY threshold.

CONCLUSION

A short course of traditional acupuncture for persistent non-specific low back pain in primary care confers a modest health benefit for minor extra cost to the NHS compared with usual care. Acupuncture care for low back pain seems to be cost effective in the longer term.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 14 Aug 2009 11:45
Last Modified: 14 Aug 2009 11:45
Published Version: http://dx.doi.org/10.1136/bmj.38932.806134.7C
Status: Published
Publisher: BMJ Publishing Group
Identification Number: 10.1136/bmj.38932.806134.7C
URI: http://eprints.whiterose.ac.uk/id/eprint/5791

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