Table 4.
Costs (Net of Baseline; 2013 US dollars) and Changes in Quality-Adjusted Life Years*
| Usual Care (UC) | Cognitive Behavioral Therapy (CBT) | Mindfulness-Based Stress Reduction (MBSR) | CBT-UC | MBSR-UC | MBSR-CBT | |
|---|---|---|---|---|---|---|
| Cost of the intervention | $0 | $150 | $150 | $150 | $150 | $0 |
| All office-based and outpatient care | $991 ($196, $2519) | $753 (−$45, $1834) | $540 (−$290, $1533) | −$237 (−$1876, $1019) | −$451 (−$2033, $743) | −$214 (−$1590, $1177) |
| Emergency department | $152 (−$92, $686) | $232 (−$140, $883) | $93 (−$30, $302) | $80 (−$462, $769) | −$59 (−$556, $231) | −$139 (−$742, $270) |
| Hospital inpatient | $902 ($280, $2973) | $1527 ($279, $3528) | $366 (−$858, $1509) | $625 (−$1211, $2490) | −$536 (−$2548, $891) | −$1160 (−$3688, $587) |
| Pharmacy | $141 ($58, $271) | $43 (−$92, $263) | $34 (−$67, $158) | −$98 (−$279, $134) | −$107 (−$262, $54) | −$9 (−$227, $169) |
| Imaging | $80 (−$11, $185) | $55 (−$32, $184) | $100 (−$34, $279) | −$24 (−$167, $129) | $20 (−$158, $207) | $45 (−$137, $253) |
|
| ||||||
| Total overall healthcare (payer) costs | $2265 ($778, $5542) | $2760 ($896, $5613) | $1283 (−$263, $3011) | $495 (−$2741, $3550) | −$982 (−$4108, $1301) | −$1477 (−$4956, $1017) |
|
| ||||||
| All office-based and outpatient care | $219 (−$31, $973) | $305 (−$31, $911) | −$17 (−$208, $303) | $86 (−$490, $652) | −$236 (−$1022, $103) | −$322 (−$942, $116) |
| Emergency department | −$14 (−$61, $0) | $3 (−$42, $100) | $12 ($0, $36) | $17 (−$37, $115) | $26 ($0, $94) | $9 (−$91, $63) |
| Hospital inpatient | $463 ($0, $2693) | $1195 ($304, $3231) | $407 ($81, $1778) | $733 (−$898, $2401) | −$55 (−$1921, $728) | −$788 (−$2573, $392) |
| Pharmacy | $10 (−$4, $27) | $3 (−$18, $35) | −$9 (−$28, $11) | −$7 (−$33, $28) | −$19 (−$43, $6) | −$12 (−$50, $15) |
| Imaging | $22 (−$16, $78) | $26 (−$11, $124) | $29 (−$11, $97) | $5 (−$58, $98) | $7 (−$56, $79) | $3 (−$108, $63) |
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| Total back-related healthcare (payer) costs, including cost of intervention | $699 ($4, $3763) | $1683 ($436, $4380) | $572 ($66, $2250) | $984 (−$1075, $3385) | −$127 (−$2670, $942) | −$1111 (−$3662, $488) |
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| Patient copay amounts | −$19 (−$191, $141) | $61 (−$112, $293) | $52 (−$58, $175) | $80 (−$161, $352) | $71 (−$124, $277) | −$9 (−$254, $194) |
| Lost productivity from absenteeism | $803 ($377, $1528) | $1004 ($411, $2008) | $1092 ($535, $1945) | $201 (−$632, $1237) | $289 (−$488, $1284) | $88 (−$942, $1053) |
| Lost productivity from presenteeism | $3254 ($4768, $4768) | $2603 ($3961, $3961) | $3153 ($4441, $4441) | −$651 ($1349, $1349) | −$101 ($1748, $1748) | $550 ($2487, $2487) |
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| Total Societal costs** | $6304 ($4193, $9805) | $6428 ($3676, $10262) | $5580 ($3465, $8343) | $125 (−$4103, $4347) | −$724 (−$4386, $2778) | −$849 (−$5338, $2662) |
|
| ||||||
| Quality-adjusted life-years (QALYs) | 0.728 (0.521, 0.936) | 0.765 (0.551, 0.978) | 0.753 (0.532, 0.975) | 0.041 (0.015, 0.067) | 0.034 (0.008, 0.060) | −0.007 (−0.035, 0.021) |
*
All confidence intervals for costs are bias-corrected and accelerated bootstrap generated 95% confidence intervals. All quality-adjusted life-year (QALY) confidence intervals are standard error-based 95% confidence intervals. Both types of confidence intervals are adjusted for missing data imputation estimate variance.
**
Total Societal costs = Total overall healthcare costs + Patient copay amounts + Lost productivity from absenteeism + Lost productivity from presenteeism