Healthcare resource utilization for chronic low back pain among high-utilizers

Area of Science:

• Health Economics
• Epidemiology
• Pain Management

Background:

• Chronic low back pain (CLBP) is a major cause of morbidity and a significant healthcare cost driver.
• Limited research exists on the long-term healthcare resource utilization of non-surgical CLBP patients, especially those with high costs.

Purpose of the Study:

• To identify patients with high-impact mechanical, CLBP.
• Quantify their related health resource utilization and associated patient characteristics.
• Hypothesize that top-quartile healthcare utilizers will sustain high costs over time.

Main Methods:

• Retrospective analysis of IBM MarketScan Research Databases (2009-2019).
• Identified US adults with CLBP (2010-2014), excluding cancer, spine surgery, pregnancy, or inflammatory conditions.
• Analyzed 5-year costs and treatment utilization (pharmacologic/non-pharmacologic), identifying high utilizers (top quartile costs in years 1-2).

Main Results:

• 4,229 of 16,917 CLBP patients were high utilizers (>$7,112 mean cost year 1, >$11,989 mean cost year 2).
• 42% of high utilizers remained in the top quartile for 2-5 years, incurring a 5-year mean cost of $43,818.
• High long-term costs associated with diabetes, more outpatient visits, pharmacologic prescriptions, and less imaging.

Conclusions:

• This study identifies a cohort of non-surgical CLBP patients with persistent high healthcare costs for up to 5 years.
• Outpatient services constituted the majority of costs.
• Further research incorporating symptom severity is needed to fully understand the economic impact of CLBP.