Objective To assess the cost-effectiveness of acupuncture for pelvic girdle and low back pain (PGLBP) during pregnancy. Design Pragmatic-open-label randomised controlled trial. Setting Five maternity hospitals Population Pregnant women with PGLBP Method 1:1 randomization to standard care or standard care plus acupuncture (5 sessions by an acupuncturist midwife). Main outcome measure Efficacy: proportion of days with self-assessed pain by numerical rating scale (NRS) ≤ 4/10. Cost effectiveness (societal viewpoint, time horizon: pregnancy): incremental cost per days with NRS ≤ 4/10. Indirect non-healthcare costs included daily compensations for sick leave and productivity loss caused by absenteeism or presenteeism. Results 96 women were allocated to acupuncture and 103 to standard care (total 199). The proportion of days with NRS ≤ 4/10 was greater in the acupuncture group than in the standard care group (61% vs 48%, p = 0.007). The mean Oswestry disability score was lower in the acupuncture group than with standard care alone (33 versus 38, Δ = 5, 95% CI: 0.8 to 9, p = 0.02). Average total costs were higher in the control group (€2947) than in the acupuncture group (€2635, Δ = —€312, 95% CI: -966 to +325), resulting from the higher indirect costs of absenteeism and presenteeism. Acupuncture was a dominant strategy when both healthcare and non-healthcare costs were included. Costs for the health system (employer and out-of-pocket costs excluded) were slightly higher for acupuncture (€1512 versus €1452, Δ = €60, 95% CI: -272 to +470). Conclusion Acupuncture was a dominant strategy when accounting for employer costs. A 100% probability of cost-effectiveness was obtained for a willingness to pay of €100 per days with pain NRS ≤ 4.

of bariatric surgery were compared with conventional treatment: adjustable gastric banding (AGB), gastric bypass (GBP) and sleeve gastrectomy (SG). Polish market share data were developed based on IFSO 2014 survey and Diagnosis-related group (DRG) catalogue. Cost data were estimated on the basis of the National Health Fund (NHF) data, publicly available Ministry of Health (MoH) data and information obtained from the literature search. Other model inputs i.e. utility/disutility values and probabilities of transitions between health states were derived from the literature. Data are presented in EUR (1 EUR = 4.00 PLN). Results: Over the course of 20 years, bariatric surgery was projected to have better net clinical benefits over conventional treatment with a substantially greater number of quality-adjusted life years (QALYs) gained (depending on the analyzed surgical technique, QALY gains were 2.42 to 2.55). There were also cost savings achieved by bariatric surgery (201.50 EUR to 1 143.75 EUR). The ICER for bariatric surgery compared to conventional treatment was dominant. Bariatric surgery was associated with a reduction of morbidity and cost savings associated with treatment of obesity-related comorbidities i.e. cancer, diabetes and cardio-vascular diseases (stroke, myocardial infarction). ConClusions: Bariatric surgery provides greater effectiveness at a lower cost compared with non-surgical treatment of morbid obesity.