Acupuncture for low
back pain is cost-effective and works, according to medical researchers.
Two studies on bmj.com suggest
a short course of acupuncture would benefit patients and healthcare providers. The cost is
well below the threshold used by officials to decide whether the NHS can afford to fund a
set treatment, they said. Up to 80% of UK residents experience back pain at some point in
their lives, costing the NHS £480m a year.
Worthwhile
The annual economic cost of low
back pain in lost productivity and disability or sickness benefits is estimated to be more
than £10bn. Evidence of acupuncture's benefits is largely inconclusive, yet 2% of the UK
population uses it in any one year. Dr Hugh MacPherson, from the University of York, along
with colleagues at Sheffield University, reached their conclusions by studying 241 adults
with low back pain. Patients were randomly assigned to either usual NHS care or up to 10
acupuncture treatment sessions. All of the patients remained under GP care. During the
two-year study period, the average total cost of back pain treatment that included
acupuncture was £460, compared with £345 for usual care. Although acupuncture was more
expensive, when the investigators took into account the health benefits gained from the
treatment in terms of quality and quantity of life, they found it was more than worthwhile
for the extra cost. The cost per quality-adjusted-life-years - or "QALY" -
gained was £4,241.
Cost-effective
This is well below the lower
threshold of £20,000 used by the National Institute for Health and Clinical Excellence to
decide whether the NHS can afford to pay for a health technology, they told bmj.com. The
patients who received acupuncture in the study reported lower pain levels and used fewer
pain killers than those who received usual NHS care. Although the differences in pain
scores between groups were small, the study authors say they represent a "clinically
worthwhile benefit" and can be viewed as a "moderate" effect. A Department
of Health spokeswoman said it was up to local NHS service providers to decide when to
provide acupuncture. The government has proposed statutory regulation of acupuncture. Mike
O'Farrell, chief executive of the British Acupuncture Council, said: "Our hope is
that after regulation, which is probably 2008, the decision makers will have increased
awareness and confidence to offer acupuncture more widely." Mike Cummings, medical
director of the British Medical Acupuncture Society, said there was good evidence that
acupuncture was cost-effective and worked beyond placebo. However, he cautioned that not
everyone with back pain would benefit from acupuncture. The work was commissioned by the
NHS Health Technology Assessment programme.
