A cost-effectiveness analysis of an internet-delivered pain management program delivered with different levels of clinician support: results from a randomised controlled trial

Blake F. Dear*, Eyal Karin, Rhiannon Fogliati, Joanne Dudeney, Olav Nielssen, Amelia J. Scott, Milena Gandy, Madelyne A. Bisby, Andreea I. Heriseanu, Taylor Hathway, Lauren Staples, Nickolai Titov, Liz Schroeder

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

There is growing interest in the potential of internet-delivered pain management programs (PMPs) to increase access to care for people with chronic pain. However, very few economic evaluations of these interventions have been reported. Using existing data, the current study examined the cost-effectiveness of an internet-delivered PMP for a mixed group chronic pain patients (n = 490) provided with different levels of clinician support. The findings indicated that each additional clinical outcome (defined as a ≥ 30% reduction in disability, depression, anxiety and pain) was associated with cost-savings when the intervention was provided in a self-guided format (ICER range: -$404 to -$808 AUD) or an optional-guided format (ICER range: -$314 to -$541 AUD), and a relatively small fixed cost when provided in the clinician-guided format (ICER range: $88 to $225 AUD). The results were driven by a reduction in service use costs among the treatment groups, which offset the costs of providing the internet-delivered PMP in the self-guided and optional-guided formats. The same general pattern of results was found when more stringent clinical outcomes (defined as a ≥ 50% reduction) were employed. These findings suggest that carefully developed and administered internet-delivered PMPs, provided with different levels of clinician support, can be highly cost effective for patients with a broad range of pain conditions. PERSPECTIVE: This study examines the cost-effectiveness of an internet-delivered pain management program provided to adults with a broad range of chronic pain conditions. Evidence of cost-effectiveness was found across a broad range of clinical outcomes and with different levels of clinician support.

Original languageEnglish
Pages (from-to)344−358
Number of pages15
JournalJournal of Pain
Volume22
Issue number3
Early online date20 Nov 2020
DOIs
Publication statusPublished - Mar 2021

Keywords

  • chronic pain
  • cost-effectiveness
  • randomised controlled trial
  • cognitive behaviour therapy
  • pain management program
  • internet
  • online

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