The study authors constructed and validated a Markov intention-to-treat model with on-year and 10-year time horizons that would estimate the cost-utility of cognitive behavioral therapy for low back pain patients.
The researchers found:
1. Incremental cost-utility of CBT was $7,197 per quality-adjusted life-year in the first year.
2. Over 10 years, the incremental cost-utility of the cognitive behavioral therapy was $5,855 per quality-adjusted live year.
3. There were robust results across several sensitivity analyses.
4. None of the parameter changes resulted in a difference of more than 7 percent from the base case for either time horizon.
5. Considering chiropractic and/or acupuncture care didn’t substantively impact cost-effectiveness.
6. When medical but not pharmaceutical costs were included, the therapy was more cost-effective:
• One year: $5,238 per QALY
• 10 years: $3,849 per QALY
“CBT is a cost-effective approach to manage chronic LBP among commercial health plans members,” concluded the study authors. “Cost-effectiveness is demonstrated for multiple plan designs.”
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