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Methodological considerations in the assessment of direct and indirect costs of back pain: A systematic scoping review

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  • Dawit T Zemedikun
  • Jesse Kigozi
  • Gwenllian Wynne-Jones
  • Alessandra Guariglia
  • Tracy Roberts

Abstract

Background: Back pain is a common and costly health problem worldwide. There is yet a lack of consistent methodologies to estimate the economic burden of back pain to society. Objective: To systematically evaluate the methodologies used in the published cost of illness (COI) literature for estimating the direct and indirect costs attributed to back pain, and to present a summary of the estimated cost burden. Methods: Six electronic databases were searched to identify COI studies of back pain published in English up to February 2021. A total of 1,588 abstracts were screened, and 55 full-text studies were subsequently reviewed. After applying the inclusion criteria, 45 studies pertaining to the direct and indirect costs of back pain were analysed. Results: The studies reported data on 15 industrialised countries. The national cost estimates of back pain in 2015 USD ranged from $259 million ($29.1 per capita) in Sweden to $71.6 billion ($868.4 per capita) in Germany. There was high heterogeneity among the studies in terms of the methodologies used for analysis and the resulting costs reported. Most of the studies assessed costs from a societal perspective (n = 29). The magnitude and accuracy of the reported costs were influenced by the case definition of back pain, the source of data used, the cost components included and the analysis method. Among the studies that provided both direct and indirect cost estimates (n = 15), indirect costs resulting from lost or reduced work productivity far outweighed the direct costs. Conclusion: Back pain imposes substantial economic burden on society. This review demonstrated that existing published COI studies of back pain used heterogeneous approaches reflecting a lack of consensus on methodology. A standardised methodological approach is required to increase credibility of the findings of COI studies and improve comparison of estimates across studies.

Suggested Citation

  • Dawit T Zemedikun & Jesse Kigozi & Gwenllian Wynne-Jones & Alessandra Guariglia & Tracy Roberts, 2021. "Methodological considerations in the assessment of direct and indirect costs of back pain: A systematic scoping review," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-17, May.
  • Handle: RePEc:plo:pone00:0251406
    DOI: 10.1371/journal.pone.0251406
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    Cited by:

    1. Philipp Näther & Jan Felix Kersten & Ingmar Kaden & Kemal Irga & Albert Nienhaus, 2022. "Distribution Patterns of Degeneration of the Lumbar Spine in a Cohort of 200 Patients with an Indication for Lumbar MRI," IJERPH, MDPI, vol. 19(6), pages 1-14, March.
    2. Stefania Di Gangi & Christophe Bagnoud & Giuseppe Pichierri & Thomas Rosemann & Andreas Plate, 2022. "Characteristics and health care costs in patients with a diagnostic imaging for low back pain in Switzerland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 823-835, July.

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