OBJECTIVES :

Herniated disk is associated with substantial morbidity and frequently treated with complementary and alternative medicine including acupuncture. Thread-embedding acupuncture using thread to continuously stimulate the acupuncture point has been suggested to potentially help patients with herniated disks. The objective of this study was to assess the cost-effectiveness of thread-embedding therapy compared to sham procedure in the patients with lumbar disk herniation.

METHODS :

Patients at the age of 19 to 70 years who were diagnosed with lumbar disk herniation within 6 months were eligible for this study. Patients were assigned to receive either thread-embedding acupuncture or sham procedure for 8 weeks with a follow-up period of additional 8 weeks (total 16 weeks). Treatment effectiveness was assessed using QALYs; QALYs were calculated using the quality weights based on the EQ-5D questionnaire. A decision tree model was constructed with treatment success defined as a reduction in the Oswestry Disability Index (ODI) of 10% or greater. The cost-effectiveness was assessed using a restricted societal perspective by including direct medical and non-medical costs.

RESULTS :

Overall, 35 and 35 patients were included in the control and intervention group, respectively, without significant differences in the baseline characteristics between the groups (p > 0.05). The estimated QALY and total cost in the control group was 0.68 and 287,795 Korean won, resulting in the average cost-effectiveness ratio (ACER) of 1,349,017 Korean Won/QALY. For the intervention group, the ACER was 1,118,225 Korean Won/QALY with the estimated QALY and total cost of 0.72 and 245,004 Korean Won, suggesting thread-embedding therapy as a potentially superior treatment option for lumbar disk herniation.

CONCLUSIONS :

In conclusion, our analysis showed the ACER of thread-embedding acupuncture was within the threshold of willingness-to-pay in Korea (3,050,000 Korean Won/QALY). Therefore, thread-embedding acupuncture might be suggested as a cost-effective treatment alternative in patients with chronic, herniated lumbar disks.