Figure 2.

Effectiveness and cost-effectiveness from the societal perspective for 17 nonpharmacologic interventions compared to usual care alone for a typical* chronic low-back pain patient population.

Each intervention represented by a solid circle is compared to the usual care arm of its study. The three interventions identified with open circles came from two studies that did not include usual care arms. For these we assigned two US-based usual care arms from other studies. The usual care arms assigned for each are: (1) Usual care (Sherman); (2) Usual care (Moore); (3) Self-care education (Cherkin 2001); (4) Usual care (Cherkin 2009). Societal costs consist of three types of costs: the cost of the intervention itself, all other direct healthcare costs, and the indirect cost of productivity loss through absenteeism to employers. Incremental societal costs are these costs for each therapy minus the costs of usual care.

*A typical chronic low-back pain patient population was assumed to have 25% of patients with low-impact chronic pain, 35% with moderate-impact chronic pain, and 40% with high-impact chronic pain. These proportions roughly correspond to the average proportions seen in the studies included in the model.