In 2007, a study led by M. Lewis and a team of researchers, the economic aspects of three physiotherapy treatments for non-specific neck disorders were thoroughly examined alongside a randomized trial. The study aimed to assess the cost-effectiveness and cost-utility of advice and exercise plus manual therapy (MT) and advice and exercise plus pulsed shortwave diathermy (PSWD), in comparison with advice and exercise alone (A&E), when administered by experienced physiotherapists.

Conducted between July 2000 and June 2002, the trial involved 350 participants with neck disorders across 15 physiotherapy departments. Participants were randomly assigned to one of the three treatment groups: A&E, MT, or PSWD. Data on outcomes and resource utilization were collected through physiotherapist case report forms and participant self-complete questionnaires. The Northwick Park Neck Pain Questionnaire (NPQ) and EuroQoL EQ-5D were utilized to measure outcomes, with the latter helping derive quality-adjusted life-year (QALY) utility scores. Two economic viewpoints were considered: healthcare and societal.

Results from the study revealed that at the 6-month mark, the mean improvement in NPQ was 11.5 for the A&E group, 10.2 for the MT group, and 10.3 for the PSWD group. Correspondingly, mean QALY scores were 0.362, 0.342, and 0.360, respectively. Regarding costs, the mean healthcare costs were pound sterling 105, pound sterling 119, and pound sterling 123 for the A&E, MT, and PSWD groups, respectively. Mean societal costs were pound sterling 373, pound sterling 303, and pound sterling 338 for each respective group.

Analysis using cost-effectiveness acceptability curves indicated that depending on the viewpoint and outcome measure considered, either A&E or MT appeared to be the most likely cost-effective interventions. Notably, PSWD consistently emerged as the least cost-effective intervention across all analyses.

In conclusion, this study suggests that for the treatment of non-specific neck disorders, the most cost-effective interventions are likely to be A&E or MT, contingent upon the economic perspective and preferred outcome measure. However, PSWD does not appear to be a cost-effective option based on the findings of this research. These insights contribute valuable information for healthcare decision-makers and practitioners in optimizing treatment strategies for individuals with neck disorders.

Reference: Lewis, M., James, M., Stokes, E., Hill, J., Sim, J., Hay, E., & Dziedzic, K. (2007). An economic evaluation of three physiotherapy treatments for non-specific neck disorders alongside a randomized trial. Rheumatology, 46(11), 1701-1708.