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 rehabilita tion in patients with chronic low back pain Design Cost utility analysis alonside a randomized con trolled 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 ran domized 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 meas ured 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 fol low up in both groups Similarly, both groups significantly reduced total monthly costs over time No significant differ ence was observed between groups The incremental cost effectneness 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