Cost - effectiveness of Preventive Interventions against Back Pain in Japanese Health Examinees

Abstract

  Objective : To evaluate the cost - effectiveness of an educational booklet and an exercise program as preventive interventions against back pain (BP) in Japanese health examinees.
  Methods : The number of people with BP in Japanese health examinees was estimated using the prevalence rates of BP in the questionnaire survey at five Japanese healthcare facilities. The loss of quality adjusted life years (QALY) associated with BP was calculated as the estimated number of people with BP multiplied by the mean differences of EQ - 5D scores between those who reported BP and those who reported no musculoskeletal pain in the questionnaire survey. The incremental cost - effectiveness ratios (ICER) were estimated based on the assumption that 4% and 25% reductions in the number of people with BP are achievable by an educational booklet and an exercise program, respectively.
  Results : Among a total of 91,594,000 health examinees aged 20 - 74 years in Japan, 13,169,000 (14.4% ) were estimated to have BP. The loss of QALY associated with BP was estimated at 776,000 years. If all the people with BP receive an educational booklet, the ICER will be 263,000 Japanese YEN/QALY. If all the people with BP receive an exercise program, the ICER will be 1,656,000 - 4,141,000 Japanese YEN/QALY. The ICER will increase with increasing ratio of participants in an exercise program to participants in an educational booklet.
  Conclusion : The estimated ICER suggested that the cost - effectiveness of both interventions was socially acceptable, but an educational booklet was more cost- effective than an educational booklet.