OBJECTIVES: The burden of low back pain is very high among the general population with significant economic and social impact on both direct and indirect costs. In Italy, each year, 30 million working hours are lost due to back sickness. Over the past two decades, several treatments have been developed to manage the various stages of the disease: acute, sub-acute and chronic. The aim of this study is to evaluate the cost-consequences of the Human Body Posturizer (HBP), according to the stage of the disease, both in terms of direct and indirect costs.

METHODS: A decision tree model was developed, to compare the traditional pathway without HBP (P1) vs the new one with HBP (P2). To estimate drugs costs, the generic prices, reimbursed by the Italian National Health System (INHS), were used. Outpatient and inpatient costs were quantified with the National tariffs while productivity loss was costed using the Italian daily Gross Domestic Product per-capita. The price of HBP was €4,550.74. The time horizon was one-year, therefore no discounts were applied.

RESULTS: For acute low back pain, the use of HBP increased direct costs from €64.04 (P1) to €332.02 (P2) without affecting indirect ones. In the sub-acute setting HBP was cost saving with direct costs from €552.48 (P1) to €347.18 (P2) and indirect ones from €900.20 (P1) to €128.60 (P2). Finally, considering the chronic stage, direct costs decreased from €1526.98 (P1) to €340.18 (P2), while indirect ones from €1,929.00 (P1) to €192.90 (P2).

CONCLUSIONS: The introduction of HBP could be a cost saving strategy in patients with sub-acute and chronic low back pain, considering both the INHS and Society perspective.