COST-EFFECTIVENESS OF INDIVIDUALISED PHYSIOTHERAPY USING THE STOPS APPROACH FOR CHRONIC LOW BACK PAIN IN BANGLADESH
Author(s)
Mohammad Ali, DPT, PhD Fellow1, Jon Ford, PhD2, Andrew Hahne, PhD2;
1Uttara Adhunik Medical College, Dhaka, Bangladesh, 2La Trobe University, Melbourne, Australia
1Uttara Adhunik Medical College, Dhaka, Bangladesh, 2La Trobe University, Melbourne, Australia
OBJECTIVES: To evaluate the cost-effectiveness of the Specific Treatment of Problems of the Spine (STOPS) approach to individualized physiotherapy, compared to usual physiotherapy care for chronic low back pain (CLBP) in Bangladesh.
METHODS: A prospective sequential comparison trial was conducted at two clinical sites. Phase 1 assessed usual care; Phase 2 involved training Bangladeshi physiotherapists to implement the STOPS approach to individualized physiotherapy; and Phase 3 evaluated STOPS. Healthcare costs (consultations, medications, imaging) were collected over six months. Health state utility scores from the EuroQOL 5D-5L were used to estimate quality adjusted life years at baseline, 5, 10, and 26 weeks. A cost-utility analysis was performed from a healthcare perspective with incremental cost-effectiveness ratios (ICERs) calculated.
RESULTS: The STOPS group had significantly lower mean total healthcare costs (BDT 4,659 ± 1,039) versus usual care (BDT 18,852 ± 55,363), with a mean difference of BDT -14,193 (95% CI: -25,635 to -2,750). Quality of life improved significantly more in the STOPS group at all timepoints, with a mean QALY difference of 0.152 (95% CI: 0.108 to 0.195) across the six-month study timeframe. STOPS dominated usual care, being both less costly and more effective.
CONCLUSIONS: The STOPS approach was cost-effective for CLBP management in Bangladesh, significantly reducing healthcare costs while improving quality of life. These findings support the feasibility of further evaluation and implementation of STOPS in Bangladesh and other low- and middle-income countries.
METHODS: A prospective sequential comparison trial was conducted at two clinical sites. Phase 1 assessed usual care; Phase 2 involved training Bangladeshi physiotherapists to implement the STOPS approach to individualized physiotherapy; and Phase 3 evaluated STOPS. Healthcare costs (consultations, medications, imaging) were collected over six months. Health state utility scores from the EuroQOL 5D-5L were used to estimate quality adjusted life years at baseline, 5, 10, and 26 weeks. A cost-utility analysis was performed from a healthcare perspective with incremental cost-effectiveness ratios (ICERs) calculated.
RESULTS: The STOPS group had significantly lower mean total healthcare costs (BDT 4,659 ± 1,039) versus usual care (BDT 18,852 ± 55,363), with a mean difference of BDT -14,193 (95% CI: -25,635 to -2,750). Quality of life improved significantly more in the STOPS group at all timepoints, with a mean QALY difference of 0.152 (95% CI: 0.108 to 0.195) across the six-month study timeframe. STOPS dominated usual care, being both less costly and more effective.
CONCLUSIONS: The STOPS approach was cost-effective for CLBP management in Bangladesh, significantly reducing healthcare costs while improving quality of life. These findings support the feasibility of further evaluation and implementation of STOPS in Bangladesh and other low- and middle-income countries.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE345
Topic
Economic Evaluation
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), STA: Alternative Medicine, STA: Multiple/Other Specialized Treatments