Chapter 6 Cost - effectiveness of adding psychomotor therapy to a multidisciplinary rehabilitation program for chronic pain

Objective. To assess the cost-effectiveness of a multidisciplinary pain rehabilitation program (TAU) with and without psychomotor therapy (PMT) for chronic pain patients. Methods. Chronic pain patients were assigned to TAU+PMT or TAU using cluster randomization. Clinical outcomes measured were health-related quality of life (HRQOL), pain-related disability (PDI) and quality-adjusted life-years (QALYs). Costs were measured from a societal perspective. Multiple imputation was used for missing data. Cost differences and incremental cost-effectiveness ratios were estimated and uncertainty was presented in cost-effectiveness (CE) planes and CE acceptability curves. Results. Ninety-four chronic pain patients were included. There were no statistically significant differences in HRQOL, PDI and QALYs between TAU+PMT and TAU. Direct costs in TAU+PMT were statistically significantly higher than in TAU. However, total societal costs in the TAU+PMT group were statistically non-significantly higher than in the TAU group (mean difference €642, 95% CI-3323 ; 4373). Cost-effectiveness analyses showed that TAU+PMT was not cost-effective in comparison with TAU for QALY, PDI and HRQOL. Conclusion. Based on the results of this study, adding PMT to a multidisciplinary treatment program is not considered cost-effective in comparison with a multidisciplinary treatment program alone. The results of this study should be interpreted with caution because of the small sample size and high drop-out.