Cost-Effectiveness of Chuna Manual Therapy and Usual Care, Compared with Usual Care Only for People with Neck Pain following Traffic Accidents: A Multicenter Randomized Controlled Trial

Abstract

This is the first cost-effectiveness analysis of Chuna manual therapy (CMT) plus usual Korean traditional medicine for traffic accident victims using a randomized controlled trial. A total of 132 participants were equally allocated to the intervention group receiving 6–11 sessions of CMT plus usual Korean traditional medicine care for three weeks or usual care including acupuncture, cupping, herbal medicine, moxibustion, and traditional physiotherapy at three hospitals. At 12 weeks, from a healthcare perspective, the intervention group had significantly higher costs (mean (SD), $778 (435) vs. $618 (318); difference, $160; 95% CI, $15 to $289; p = 0.005). From a societal perspective, total costs were insignificantly lower in the intervention group (mean (SD), $1077 (1081) vs. $1146 (1485); difference, $−69; 95% CI, $−568 to $377; p = 0.761). The intervention group dominated, with significantly higher QALYs gained at lower overall cost with a 72% chance of being cost-effective. From a societal perspective, the intervention was cost-saving for individuals who had neck pain after car accidents, although it was not cost-effective from the healthcare perspective ($40,038 per QALY gained). Findings support use of CMT as an integrated care treatment for whiplash from a societal perspective. Further studies with larger sample sizes are needed to determine cost-effectiveness in other cultural contexts.

Adaptation and Dissemination of Korean Medicine Clinical Practice Guidelines for Traffic Injuries

“…CMT and pharmacopuncture are frequently used together. This cost-effective combination is more efficient for acquiring incremental quality-adjusted life-years from social and health management standpoints when treating traffic injuries [ 12 ]. According to the expert consensus, the CPG development committee assigned a GoR of B because the benefit was greater than the harm in the medical setting.…”

“…Hence, the existing CQ section focusing on patients and interventions was preserved; however, the section focused on pain was subdivided, and the evidence was updated based on further literature and systematic research findings from February 2020 to April 2020. Additional surveys, qualitative research, and an economic evaluation have been conducted to obtain sufficient evidence during the CPG development phase [ 10 , 11 , 12 ]. The development committee also studied other CPG related to traffic injuries, recommendations comparable to Korean medicine therapeutic interventions, LoEs, GoRs, and descriptions of the differences between the previous CPG found in the literature.…”

Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis

“…[ 9 ] However, pharmacologic therapy is not recommended for chronic pain because it can damage liver and provoke hemorrhagic gastritis. [ 11 ] For the second-line treatment, physiotherapy and exercises are advocated as effective treatments for chronic LBP. [ 8 ] There is evidence of effective treatment for chronic pain by therapy over 12 months.…”