OBJECTIVES:Traditional Chinese Medicines (TCMs), as well as physiotherapy and chemical drugs, are recommended for the treatment of cervical spondylosis by Chinese cervical spondylosis diagnosis and treatment guide. The aim of this study is to evaluate whether Jingshu Granules is cost-effective in patients with cervical radiculopathy in China.

METHODS:A multicenter, double-blinded, randomized controlled trial was performed. A total of 480 patients were recruited from 14 tertiary hospitals in China and were randomly divided into the experimental group (Jingshu Granules) and the control group(placebo) in a 3:1 ratio. All patients received 4 weeks’ treatment. The clinical outcomes and costs data were collected during the trail which including the visual analogue scale (VAS) of pain, SF-36 score, WTP for above indicators, neck disability index(NDI), direct medical costs and transport costs. From the social perspective, a decision-tree model was constructed and cost-effectiveness analysis was conducted.

RESULTS:The experimental group has a significant advantage of improving NDI(9.41±10.51 vs 4.83±8.43,p<0.05) and VAS of pain(22.72±15.08 vs 12.86±13.45,p<0.05), while there was no significant difference in the improvement of QoL (SF-36 score, P=0.689).The expected cost of experimental group was US $172.75; the effective rates were 57.9% for neck disability index and 72.9% for VAS of pain; The expected cost of control group was US $114.31,the effective rates were 33.3% for NDI and 51.6% for VAS of pain. For the primary indicator (VAS of pain), the incremental cost-effectiveness ratio was 267.27. The median WTP for pain cure of patients was US $302.11. Setting WTP as threshold, the Jingshu Granules showed to be a cost-effectiveness strategy.

CONCLUSIONS : Jingshu Granules was proved to be effective for the patients with cervical radiculopathy. Even compared with placebo, it is cost-effective when considering VAS of pain as the clinical outcome indicator. Longer-term clinical study should be taken to figure out the impact on QoL of patients.