Economic Evaluation of an Interdisciplinary Pain Self-Management Program

Abstract

The burden of disabling chronic pain conditions in the working age population, is compounded by a combination of higher costs of health care services and lost work income. The recognition of these multiple burdens, for both the individuals concerned, their immediate families, as well as for employers and the general community, has led to calls for more cost-effective pain management for adults with chronic pain. Interdisciplinary chronic pain management interventions have been found to be effective in reducing disability due to chronic pain in working age adults, but little is known about the cost-effectiveness of such interventions.

Economic evaluation requires that assessment measures should be standardised, time efficient and aimed to collect information on chronic pain patients’ health, productivity gain, quality of life and health care utilization costs to inform decision makers and payers to aid their funding decisions.

The first two studies in this thesis included a systematic review of the cost-effectiveness of chronic pain management programs to identify what proportion of interdisciplinary pain management programs are cost-effective and the productivity outcome of such interventions. The third study involved an economic analysis of an interdisciplinary self-management program for chronic pain patients called ADAPT (Active Day Patient Treatment) in Sydney using patient reported hospital administrative data comparing patients’ pre-treatment and 1 month follow-up labour force participation, health and health care services utilization outcomes. The fourth study evaluated the cost-effectiveness of ADAPT comparing patients’ pre-treatment and >12 months follow-up data including patients’ labour force participation, quality of life and health care services utilization information.

The overall findings suggest patients had improved labour force participation, better health and quality of life; and reduced healthcare utilization costs after participating in ADAPT.