Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation
Yves Henchoz1, Christophe Pinget, Jean-Blaise Wasserfallen
1Institute of Sport Sciences of the University of Lausanne, Lausanne, Switzerland. yves.henchoz@unil.ch
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.
