Cost-effectiveness analysis of active day patient treatment, an interdisciplinary pain self-management program

Introduction: Active day patient treatment (ADAPT) is an interdisciplinary, multimodal pain management program for patients with disabling chronic pain at the Pain Management & Research Centre (PMRC), Royal North Shore Hospital in Sydney, Australia. Objective: The aim of this study was to analyse the cost-effectiveness of ADAPT using hospital administrative and patient reported >12-month follow-up data. Patients' preprogram labour force participation, health care utilization costs, and quality of life outcomes were compared with outcomes >12 months after participating the program. Methods: This retrospective cohort study included 61 patients who completed ADAPT (including follow-up) between 2014 and 2017 at the PMRC. Primary outcome measures were labour force participation in patients' average weekly earnings (n = 61) and incremental cost-effectiveness ratio (ICERs) (n = 53) based on the health utility score derived from assessment of quality of life (AQoL-8D). Pain-related health care utilization and costs before and >12 months after the program were assessed to calculate the ICER. Results: We estimated patients were earning $628.99 per week at >12 month after participating in ADAPT comparing to $539.54 at baseline. The ICER was $20,228.76 (95% CI: $14,176.25-$27,826.33) per quality adjusted life years gained. Conclusion: Results from this study indicated that, patients with chronic pain >12 months after participating in ADAPT reported higher quality of life scores along with reduced health care utilization costs. However, more robust and exhaustive studies, especially prospective studies, are required to confirm these findings.