COST-EFFECTIVENESS ANALYSIS OF THRUST CHUNA MANUAL THERAPY COMPARED WITH NON-THRUST CHUNA OR USUAL CARE IN PATIENTS WITH NON-ACUTE LOW BACK PAIN
Author(s)
Soomi Jo, BS1, Hyeonjung Park, BPharm1, Sun-Young Park, PharmD, MS2, Yeong-Jae Shin, MS, PhD3, Byung-Cheul Shin, MS, MPH, PhD4, In-Hyuk Ha, MPH, PhD5, Sanghun Lee, MS, PhD6, Hae Sun Suh, MA, MS, PhD7;
1Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Korea, Republic of, 2Department of Korean Medicine, School of Korean Medicine, Pusan National University, Yangsan, Korea, Republic of, 3Department of Korean Medicine Rehabilitation, Spine and Joint Center, Pusan National University Korean Medicine Hospital,, Yangsan, Korea, Republic of, 4Department of Korean Medicine Rehabilitation, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan, Korea, Republic of, 5Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea, Republic of, 6Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 7College of Pharmacy, Kyung Hee University, Seoul, Korea, Republic of
1Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, Korea, Republic of, 2Department of Korean Medicine, School of Korean Medicine, Pusan National University, Yangsan, Korea, Republic of, 3Department of Korean Medicine Rehabilitation, Spine and Joint Center, Pusan National University Korean Medicine Hospital,, Yangsan, Korea, Republic of, 4Department of Korean Medicine Rehabilitation, Spine and Joint Center, Pusan National University Korean Medicine Hospital, Yangsan, Korea, Republic of, 5Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea, Republic of, 6Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 7College of Pharmacy, Kyung Hee University, Seoul, Korea, Republic of
OBJECTIVES: This study aimed to evaluate the cost-effectiveness of thrust chuna manual therapy (CMT) compared with non-thrust CMT or usual care (UC) from a societal perspective in patients with non-acute low back pain (LBP).
METHODS: A randomized controlled trial enrolled 81 adults with non-acute LBP, who were allocated equally to thrust (complex) CMT, non-thrust (simple) CMT, or UC. Participants received 12 treatment sessions over 4 weeks, followed by an 8-week observation period. Costs (medical, non-medical, and productivity loss) were evaluated from a societal perspective, with productivity loss costs measured using the Korean Institute of Medical Technology Assessment Productivity Cost Questionnaire. Quality-adjusted life years (QALYs) were estimated using EuroQol-5 Dimensions 5 Levels. Incremental cost-utility ratios (ICURs) were calculated, and uncertainty was assessed using probabilistic sensitivity analysis (PSA) with 1,000 iterations. A per-protocol approach was used, including only participants with complete data.
RESULTS: Thrust CMT demonstrated the highest QALY gain (0.183 [SD 0.010]), followed by non-thrust CMT (0.179 [SD 0.018]) and UC (0.166 [SD 0.027]) over the 12-week study period (p=0.004). From the societal perspective, total costs were lower for thrust CMT ($696 [SD 159]) and non-thrust CMT ($680 [SD 428]) than UC ($1,361 [SD 2,787]; p=0.061), primarily due to reduced productivity loss costs ($121, $254, and $1,117, respectively; p=0.294). Thrust CMT dominated UC by incurring lower costs with greater benefits. Compared with non-thrust CMT, the ICUR was $4,079/QALY. At a willingness-to-pay threshold of $34,046 per QALY, corresponding to Korea’s 2024 Gross Domestic Product per capita, PSA showed a >90% probability of thrust CMT being cost-effective against UC, and ~60% against non-thrust CMT.
CONCLUSIONS: Thrust CMT for non-acute LBP was more cost-effective than UC and non-thrust CMT from a societal perspective and may represent a valuable non-pharmacological option for reimbursement and healthcare resource allocation.
METHODS: A randomized controlled trial enrolled 81 adults with non-acute LBP, who were allocated equally to thrust (complex) CMT, non-thrust (simple) CMT, or UC. Participants received 12 treatment sessions over 4 weeks, followed by an 8-week observation period. Costs (medical, non-medical, and productivity loss) were evaluated from a societal perspective, with productivity loss costs measured using the Korean Institute of Medical Technology Assessment Productivity Cost Questionnaire. Quality-adjusted life years (QALYs) were estimated using EuroQol-5 Dimensions 5 Levels. Incremental cost-utility ratios (ICURs) were calculated, and uncertainty was assessed using probabilistic sensitivity analysis (PSA) with 1,000 iterations. A per-protocol approach was used, including only participants with complete data.
RESULTS: Thrust CMT demonstrated the highest QALY gain (0.183 [SD 0.010]), followed by non-thrust CMT (0.179 [SD 0.018]) and UC (0.166 [SD 0.027]) over the 12-week study period (p=0.004). From the societal perspective, total costs were lower for thrust CMT ($696 [SD 159]) and non-thrust CMT ($680 [SD 428]) than UC ($1,361 [SD 2,787]; p=0.061), primarily due to reduced productivity loss costs ($121, $254, and $1,117, respectively; p=0.294). Thrust CMT dominated UC by incurring lower costs with greater benefits. Compared with non-thrust CMT, the ICUR was $4,079/QALY. At a willingness-to-pay threshold of $34,046 per QALY, corresponding to Korea’s 2024 Gross Domestic Product per capita, PSA showed a >90% probability of thrust CMT being cost-effective against UC, and ~60% against non-thrust CMT.
CONCLUSIONS: Thrust CMT for non-acute LBP was more cost-effective than UC and non-thrust CMT from a societal perspective and may represent a valuable non-pharmacological option for reimbursement and healthcare resource allocation.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE346
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)