Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain

J Rehabil Med. 2010 Oct;42(9):846-52. doi: 10.2340/16501977-0610.


Objective: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain.

Design: Cost-utility analysis alongside a randomized controlled trial.

Subjects/patients: A total of 105 patients with chronic low back pain.

Methods: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups.

Results: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros.

Conclusion: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Cost of Illness
  • Cost-Benefit Analysis
  • Exercise Therapy / economics*
  • Exercise Therapy / methods
  • Female
  • Follow-Up Studies
  • Health Care Costs
  • Humans
  • Low Back Pain / economics
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Quality-Adjusted Life Years
  • Surveys and Questionnaires
  • Switzerland
  • Treatment Outcome
  • Young Adult