A Review of Economic Factors Related to the Delivery of Health Care for Chronic Low Back Pain

We describe tools used to evaluate the economic impact of health care interventions, discuss the economic burden of chronic low back pain, and review evidence on the cost‐effectiveness of treating failed back surgery syndrome with spinal cord stimulation, intrathecal drug delivery, acupuncture, epidural injections, disc prosthesis, lumbar fusion, and noninvasive therapies. We also mention the lack of cost studies for emerging therapies, such as vibrotherapy and peripheral nerve field stimulation. Topics include types of cost studies; the economic perspectives taken by such studies; direct and indirect costs; measures of success; definitions of cost‐effectiveness, incremental cost‐effectiveness, incremental cost‐utility ratios, and quality‐adjusted life years; the concept of maximum willingness to pay; and the use of cost‐effectiveness models.

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