OBJECTIVES: Lumbosacral radiculopathy, characterized by lower back nerve root pain, is a leading cause of activity limitations and healthcare costs, including indirect costs. This study performed cost-utility analysis comparing acupoomy combined with Nerve Block Therapy (NBT) and NBT alone.

METHODS: A randomized controlled study was conducted over seven weeks in 2022, enrolling lumbosacral patients aged 18-85 years with a numeric rating scale score of less than 5. Utility values were measured using the 5-level EuroQol 5-dimensional questionnaire , and quality-adjusted life-years (QALYs) were calculated for the study period. Direct costs, which include direct medical and non-medical expenses, as well as productivity loss costs, were estimated from a societal perspective. To assess productivity loss costs, the iMTA Productivity Cost Questionnaire was utilized.

RESULTS: Fifty patients were enrolled, 25 in the Acupotomy with NBT group and 25 in the NBT group (mean age: 62.0 years, female: 58.0%). The overall costs, including direct and indirect costs, were $605 for the Acupotomy with NBT group and $751 for the NBT group. The incremental QALYs for the Acupotomy with NBT group compared to the NBT group were 0.01 QALYs, and the incremental overall costs were -$146. The incremental cost-utility ratios (ICUR) of Acupotomy with NBT over NBT were -$14,009/QALY, indicating the dominance of combination therapy. Additionally, the total productivity loss costs for the Acupotomy with NBT group and NBT group were $465 and $712, respectively, representing a decrease of productivity loss costs from Acupotomy with NBT group.

CONCLUSIONS: Acupotomy with NBT demonstrated improved quality of life and lower costs compared to NBT alone. This could be considered a primary treatment option for lumbosacral radiculopathy due to its cost-effectiveness and positive impact on quality of life from a societal perspective.