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Cost Effectiveness of Acupuncture for Chronic Neck Pain (N=3451)

Cost Effectiveness of Acupuncture for Chronic Neck Pain (N=3451) AIM September 2006 text.qxd 27/09/2006 09:08 Page 141 Research shorts Cost effectiveness of acupuncture for chronic Will purchasers of health care be satisfied with this neck pain (n=3451) data? It is probable that most will be, but there will still be sceptics who say that for some conditions Willich SN, Reinhold T, Selim D, Jena S, Brinkhaus acupuncture is no more than a sophisticated placebo, B, Witt CM. Cost-effectiveness of acupuncture and whether it is cost effective or not, we should not treatment in patients with chronic neck pain. Pain knowingly purchase and use interventions that are 2006. not clearly efficacious. This will be an interesting ethical debate that is likely to run for some time… at The objective of this study was to assess costs and least until the truth is out! cost effectiveness of additional acupuncture treatment in patients with chronic neck pain compared to Mike Cummings patients receiving routine care alone. It was a randomised controlled multicentre trial, set in a Reference List 1. Thomas KJ, MacPherson H, Ratcliffe J, Thorpe L, Brazier general practice in Germany. J, Campbell M et al. Longer term clinical and economic Patients in the acupuncture group received 10 to benefits of offering acupuncture care to patients with chronic 15 acupuncture sessions over three months. Atotal of low back pain. Health Technol Assess 2005;9(32):iii-x, 1. 2. Wonderling D, Vickers AJ, Grieve R, McCarney R. Cost 3451 patients (1753 acupuncture group, 1698 control effectiveness analysis of a randomised trial of acupuncture group) were randomised (31% men, age 53.5±12.9 for chronic headache in primary care. BMJ 2004; years; 69% women, 49.2±12.7 years). Acupuncture 328(7442):747. treatment was associated with significantly higher 3. Witt CM, Jena S, Selim D, Brinkhaus B, Reinhold T, Wruck K et al. Pragmatic randomized trial evaluating the clinical costs over the three months study duration compared and economic effectiveness of acupuncture for chronic low to routine care (€ 925.53±1551.06 vs back pain. Am J Epidemiol 2006;164(5):487-96. € 648.06±1459.13; mean difference: € 277.47 [95% CI: € 175.71–€ 379.23]). This cost increase was mainly due to costs of acupuncture (€ 361.76±90.16). The ICER was € 12 469 per QALYgained and proved robust in additional sensitivity analyses. Since health insurance databases were used, private medical expenses such as over the counter medication were not included. As we are presented with more of the data from the Modellvorhaben (trial phases) of the German health insurance companies, combined with the existing data from RCTs of acupuncture, a certain pattern seems to be developing. We can be increasingly confident about the effectiveness of acupuncture in a number of painful conditions, but data on specific efficacy (ie efficacy beyond placebo) appears somewhat more elusive. This trial provides rigorous data that applying acupuncture in routine care is a cost effective intervention. Over the last couple of years we have seen the first rigorous economic analyses of 1;2 acupuncture, and they all confirm that acupuncture confers a relatively modest incremental cost per QALY. We have data on chronic headache, chronic low back pain and now, with this paper, chronic neck pain (and there are more figures in the pipeline from the Modellvorhaben). ACUPUNCTURE IN MEDICINE 2006;24(3):138-141. www.medical-acupuncture.co.uk/aimintro.htm 141 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

Cost Effectiveness of Acupuncture for Chronic Neck Pain (N=3451)

Cummings, Mike
Acupuncture in Medicine , Volume 24 (3): 1 – Sep 1, 2006
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References (4)

Publisher
SAGE
Copyright
© 2006 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/aim.24.3.141
Publisher site
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Abstract

AIM September 2006 text.qxd 27/09/2006 09:08 Page 141 Research shorts Cost effectiveness of acupuncture for chronic Will purchasers of health care be satisfied with this neck pain (n=3451) data? It is probable that most will be, but there will still be sceptics who say that for some conditions Willich SN, Reinhold T, Selim D, Jena S, Brinkhaus acupuncture is no more than a sophisticated placebo, B, Witt CM. Cost-effectiveness of acupuncture and whether it is cost effective or not, we should not treatment in patients with chronic neck pain. Pain knowingly purchase and use interventions that are 2006. not clearly efficacious. This will be an interesting ethical debate that is likely to run for some time… at The objective of this study was to assess costs and least until the truth is out! cost effectiveness of additional acupuncture treatment in patients with chronic neck pain compared to Mike Cummings patients receiving routine care alone. It was a randomised controlled multicentre trial, set in a Reference List 1. Thomas KJ, MacPherson H, Ratcliffe J, Thorpe L, Brazier general practice in Germany. J, Campbell M et al. Longer term clinical and economic Patients in the acupuncture group received 10 to benefits of offering acupuncture care to patients with chronic 15 acupuncture sessions over three months. Atotal of low back pain. Health Technol Assess 2005;9(32):iii-x, 1. 2. Wonderling D, Vickers AJ, Grieve R, McCarney R. Cost 3451 patients (1753 acupuncture group, 1698 control effectiveness analysis of a randomised trial of acupuncture group) were randomised (31% men, age 53.5±12.9 for chronic headache in primary care. BMJ 2004; years; 69% women, 49.2±12.7 years). Acupuncture 328(7442):747. treatment was associated with significantly higher 3. Witt CM, Jena S, Selim D, Brinkhaus B, Reinhold T, Wruck K et al. Pragmatic randomized trial evaluating the clinical costs over the three months study duration compared and economic effectiveness of acupuncture for chronic low to routine care (€ 925.53±1551.06 vs back pain. Am J Epidemiol 2006;164(5):487-96. € 648.06±1459.13; mean difference: € 277.47 [95% CI: € 175.71–€ 379.23]). This cost increase was mainly due to costs of acupuncture (€ 361.76±90.16). The ICER was € 12 469 per QALYgained and proved robust in additional sensitivity analyses. Since health insurance databases were used, private medical expenses such as over the counter medication were not included. As we are presented with more of the data from the Modellvorhaben (trial phases) of the German health insurance companies, combined with the existing data from RCTs of acupuncture, a certain pattern seems to be developing. We can be increasingly confident about the effectiveness of acupuncture in a number of painful conditions, but data on specific efficacy (ie efficacy beyond placebo) appears somewhat more elusive. This trial provides rigorous data that applying acupuncture in routine care is a cost effective intervention. Over the last couple of years we have seen the first rigorous economic analyses of 1;2 acupuncture, and they all confirm that acupuncture confers a relatively modest incremental cost per QALY. We have data on chronic headache, chronic low back pain and now, with this paper, chronic neck pain (and there are more figures in the pipeline from the Modellvorhaben). ACUPUNCTURE IN MEDICINE 2006;24(3):138-141. www.medical-acupuncture.co.uk/aimintro.htm 141

Journal

Acupuncture in Medicine – SAGE

Published: Sep 1, 2006

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