TY - JOUR
T1 - Cost-effectiveness analysis of app-delivered self-management support (selfBACK) in addition to usual care for people with low back pain in Denmark
AU - Kongstad, Line Planck
AU - Øverås, Cecilie Krage
AU - Skovsgaard, Christian Volmar
AU - Sandal, Louise Fleng
AU - Hartvigsen, Jan
AU - Søgaard, Karen
AU - Mork, Paul Jarle
AU - Stochkendahl, Mette Jensen
N1 - © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/9/5
Y1 - 2024/9/5
N2 - OBJECTIVES: This study aims to investigate the cost-effectiveness of individually tailored self-management support, delivered via the artificial intelligence-based selfBACK app, as an add-on to usual care for people with low back pain (LBP).DESIGN: Secondary health-economic analysis of the selfBACK randomised controlled trial (RCT) with a 9-month follow-up conducted from a Danish national healthcare perspective (primary scenario) and a societal perspective limited to long-term productivity in the form of long-term absenteeism (secondary scenario).SETTING: Primary care and an outpatient spine clinic in Denmark.PARTICIPANTS: A subset of Danish participants in the selfBACK RCT, including 297 adults with LBP randomised to the intervention (n=148) or the control group (n=149).INTERVENTIONS: App-delivered evidence-based, individually tailored self-management support as an add-on to usual care compared with usual care alone among people with LBP.OUTCOME MEASURES: Costs of healthcare usage and productivity loss, quality-adjusted life-years (QALYs) based on the EuroQol-5L Dimension Questionnaire, meaningful changes in LBP-related disability measured by the Roland-Morris Disability Questionnaire (RMDQ) and the Pain Self-Efficacy Questionnaire (PSEQ), costs (healthcare and productivity loss measured in Euro) and incremental cost-effectiveness ratios (ICERs).RESULTS: The incremental costs were higher for the selfBACK intervention (mean difference €230 (95% CI -136 to 595)), where ICERs showed an increase in costs of €7336 per QALY gained in the intervention group, and €1302 and €1634 for an additional person with minimal important change on the PSEQ and RMDQ score, respectively. At a cost-effectiveness threshold value of €23250, the selfBACK intervention has a 98% probability of being cost-effective. Analysis of productivity loss was very sensitive, which creates uncertainty about the results from a societal perspective limited to long-term productivity.CONCLUSIONS: From a healthcare perspective, the selfBACK intervention is likely to represent a cost-effective treatment for people with LBP. However, including productivity loss introduces uncertainty to the results.TRIAL REGISTRATION NUMBER: NCT03798288.
AB - OBJECTIVES: This study aims to investigate the cost-effectiveness of individually tailored self-management support, delivered via the artificial intelligence-based selfBACK app, as an add-on to usual care for people with low back pain (LBP).DESIGN: Secondary health-economic analysis of the selfBACK randomised controlled trial (RCT) with a 9-month follow-up conducted from a Danish national healthcare perspective (primary scenario) and a societal perspective limited to long-term productivity in the form of long-term absenteeism (secondary scenario).SETTING: Primary care and an outpatient spine clinic in Denmark.PARTICIPANTS: A subset of Danish participants in the selfBACK RCT, including 297 adults with LBP randomised to the intervention (n=148) or the control group (n=149).INTERVENTIONS: App-delivered evidence-based, individually tailored self-management support as an add-on to usual care compared with usual care alone among people with LBP.OUTCOME MEASURES: Costs of healthcare usage and productivity loss, quality-adjusted life-years (QALYs) based on the EuroQol-5L Dimension Questionnaire, meaningful changes in LBP-related disability measured by the Roland-Morris Disability Questionnaire (RMDQ) and the Pain Self-Efficacy Questionnaire (PSEQ), costs (healthcare and productivity loss measured in Euro) and incremental cost-effectiveness ratios (ICERs).RESULTS: The incremental costs were higher for the selfBACK intervention (mean difference €230 (95% CI -136 to 595)), where ICERs showed an increase in costs of €7336 per QALY gained in the intervention group, and €1302 and €1634 for an additional person with minimal important change on the PSEQ and RMDQ score, respectively. At a cost-effectiveness threshold value of €23250, the selfBACK intervention has a 98% probability of being cost-effective. Analysis of productivity loss was very sensitive, which creates uncertainty about the results from a societal perspective limited to long-term productivity.CONCLUSIONS: From a healthcare perspective, the selfBACK intervention is likely to represent a cost-effective treatment for people with LBP. However, including productivity loss introduces uncertainty to the results.TRIAL REGISTRATION NUMBER: NCT03798288.
KW - Humans
KW - Low Back Pain/therapy
KW - Cost-Benefit Analysis
KW - Denmark
KW - Self-Management/methods
KW - Male
KW - Female
KW - Mobile Applications/economics
KW - Middle Aged
KW - Adult
KW - Quality-Adjusted Life Years
KW - Cost-Effectiveness Analysis
U2 - 10.1136/bmjopen-2024-086800
DO - 10.1136/bmjopen-2024-086800
M3 - Journal article
C2 - 39242164
SN - 2044-6055
VL - 14
SP - e086800
JO - BMJ Open
JF - BMJ Open
IS - 9
ER -