Cost effectiveness of virtual reality game compared to clinic based McKenzie extension therapy for chronic non-specific low back pain

Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953, Gebrye, Tadesse ORCID: https://orcid.org/0000-0001-7976-2013, Mbada, Chidozie Emmanuel, Fatoye, Clara Toyin, Makinde, Moses Oluwatosin, Ayomide, Salami and Blessing, Ige (2022) Cost effectiveness of virtual reality game compared to clinic based McKenzie extension therapy for chronic non-specific low back pain. British Journal of Pain, 16 (6). pp. 601-609. ISSN 2049-4637

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Abstract

Background: Low-back pain (LBP) is a major public health problem globally and its direct and indirect healthcare costs are growing rapidly. Virtual reality involving the use of video games or non-game applications are alternatives to conventional face-to-face physical therapy for LBP. The purpose of this study was to assess the cost-effectiveness of Back Extension- Virtual Reality Game (BE-VRG) compared to Clinic-based McKenzie therapy (CBMT) for chronic non-specific LBP in Nigeria. Methods: Patients with chronic non-specific LBP were randomised into either BE-VRG or CBMT group. Patients’ level of disability was assessed using Oswestry Disability Index (ODI) at week 4 and week 8. ODI was mapped to SF-6D to generate quality adjusted life years (QALYs) used for cost-effectiveness analysis. Resource use and costs were assessed based on rehabilitation services from a healthcare perspective. Cost-effectiveness analysis which included direct healthcare costs was conducted. Incremental cost per QALY was also calculated. Results: Forty-six patients (BE-VRG, n = 22; CBMT, n = 24) with the mean (± SD) age of 32.6 ± (11.5) years for BE-VRG and 48.8± (10.2) years for CBMT intervention completed in this study. The mean direct health costs per patient were USD100.67 and USD106.3 for BE-VRG and CBMT, respectively. The mean quality adjusted life years at week 4 and week 8 were (BE-VRG, 0.0574 ± (0.002); CBMT, 0.0548 ± (0.002)); and (BE-VRG; 0.116 ± (0.002); CBMT; 0.114 ± (0.004)), respectively. ICER showed that BE-VRG arm was less costly and more effective than CBMT. Conclusion: The findings of this study suggest that BE-VRG was cost saving for chronic non-specific LBP compared to CBMT. This evidence could guide policy makers, payers, and clinicians in evaluating BE-VRG as a treatment option for people with chronic non-specific LBP.