In 2007, a study conducted by Manca et. al., delves into the cost-effectiveness of two distinct physiotherapy interventions for managing back and neck pain in primary care settings. The study compares a brief pain management approach rooted in cognitive-behavioral principles, termed the Solution-Finding Approach, with the more conventional McKenzie Approach.

The investigation, which ran alongside a randomized trial, scrutinized the incremental variances in costs and benefits associated with the Solution-Finding and McKenzie approaches over a 12-month period. Costs were meticulously assessed in UK pounds sterling, while benefits were gauged using health-related quality of life metrics, specifically the EQ-5D, to derive patient-specific quality-adjusted life years (QALYs).

The findings revealed that individuals receiving McKenzie treatment necessitated, on average, one additional physiotherapist visit compared to those undergoing the Solution-Finding Approach (4.15 vs. 3.10 visits). Interestingly, over the 12-month period, the Solution-Finding Approach exhibited a lower per-patient cost, amounting to pound-24.4 (with a 95% confidence interval ranging from pound-49.6 to 0.789 pounds). However, when assessing the mean difference in QALYs between the two groups, it was found to be -0.020 (with a 95% confidence interval from -0.057 to 0.017), favoring the McKenzie Approach.

Calculating the incremental cost-effectiveness ratio, which juxtaposes mean costs with QALYs gained, yielded a figure of 1220 pounds (-24.4/-0.020). This suggests that the McKenzie treatment demonstrates cost-effectiveness when compared to the Solution-Finding Approach.

Conclusively, the results underscore the potential value in investing in the McKenzie treatment, despite its additional associated costs, owing to the purported added benefits it offers. Nonetheless, the researchers advocate for further exploration to ascertain the generalizability of the variance in physiotherapy visits observed between the two strategies across diverse treatment settings.

Reference: Manca, A., Dumville, J. C., Torgerson, D. J., Klaber Moffett, J. A., Mooney, M. P., Jackson, D. A., & Eaton, S. (2007). Randomized trial of two physiotherapy interventions for primary care back and neck pain patients: cost–effectiveness analysis. Rheumatology, 46(9), 1495-1501.