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A cost-utility analysis of pharmacopuncture versus physiotherapy for chronic low back pain: A multicenter, pragmatic randomized controlled trial.

Integrative medicine research·December 2025·Ye-Seul Lee, Soo Jin Kim, Kyung Sun Park et al.
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Key Finding

Pharmacopuncture demonstrated superior cost-effectiveness compared to physical therapy for chronic low back pain, with an incremental cost-effectiveness ratio of $16,575 per QALY from the healthcare perspective and lower overall costs from the societal perspective.

What This Means For You

Chronic low back pain affects millions of people worldwide, causing disability and lost work time. While physical therapy is a common treatment, researchers wanted to know if pharmacopuncture—a technique combining acupuncture with herbal medicine injections at acupoint sites—might be a better option. This study compared the cost-effectiveness of pharmacopuncture to standard physical therapy for people with chronic low back pain. Researchers enrolled 100 patients and randomly assigned them to receive either pharmacopuncture or physical therapy, with both groups receiving 10 treatment sessions over five weeks. They measured quality of life improvements and calculated costs, including medical expenses and lost productivity from missing work. The results showed that pharmacopuncture was more cost-effective than physical therapy, especially when considering societal costs like work absences. From the healthcare system perspective alone, pharmacopuncture cost approximately $16,575 per quality-adjusted life year gained, which falls within acceptable cost-effectiveness ranges. Patients receiving pharmacopuncture experienced better quality of life improvements relative to costs compared to those receiving physical therapy. This suggests that pharmacopuncture could be a valuable treatment option for people struggling with chronic low back pain, potentially offering better value than conventional physical therapy. However, the researchers note that larger studies with longer follow-up periods are needed to confirm these findings. If you're considering acupuncture or pharmacopuncture for chronic low back pain, seek treatment from a licensed acupuncturist trained in these specialized techniques.

Clinical Notes for Practitioners

This multicenter randomized controlled trial (n=100) evaluated the cost-utility of pharmacopuncture (PPT) versus physical therapy (PT) for chronic low back pain from healthcare system and societal perspectives. Patients received 10 treatment sessions over five weeks. Utility was measured using EQ-5D-5L to calculate quality-adjusted life years (QALYs), with costs including medical expenses and productivity loss assessed via the WPAI questionnaire. Incremental cost-effectiveness ratios were calculated with bootstrapping and sensitivity analyses. From the healthcare perspective, PPT demonstrated an ICER of $16,575 per QALY gained. From the societal perspective, PPT showed superior cost-effectiveness with lower overall costs and improved QALYs compared to PT. Sensitivity analyses confirmed robustness of findings. Clinical implications suggest PPT represents a cost-effective alternative to conventional PT for chronic low back pain management, though larger studies with extended follow-up are warranted to validate these preliminary findings and establish optimal treatment protocols.

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