Methodological quality of economic evaluations of new pharmaceuticals in The Netherlands.

Background: In the Netherlands, decisions about the reimbursement of new pharmaceuticals are based on cost effectiveness, as well as therapeutic value and budget impact. Since 1 January 2005, drug manufacturers are formally required to substantiate the cost effectiveness of drugs that have therapeutic added value in comparison with existing ones through pharmacoeconomic evaluations. Dutch guidelines for pharmacoeconomic research provide methods guidance, ensuring consistency in both the evidence and the decision-making process about drug reimbursement.

[Cost-effectiveness of new drugs impacts reimbursement decision making but room for improvement].

Objective: For new drugs to be included in appendix 1B of the drug reimbursement system, they must have proven added therapeutic value, an acceptable budget impact, and be cost-effective. To validate the latter, pharmacoeconomic evaluations have become mandatory. These evaluations should adhere to guidelines for pharmacoeconomic research.

Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial.

Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapists in 49 practices and 114 patients with non-specific low back pain of more than 12 weeks duration participated in the study.

Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.

Study Design: Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks.

Objective: To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain. The intensive group training protocol combines exercise therapy, back school, and behavioral principles.

Low back pain in general practice: cost-effectiveness of a minimal psychosocial intervention versus usual care.

An intervention that can prevent low back pain (LBP) becoming chronic, may not only prevent great discomfort for patients, but also save substantial costs for the society. Psychosocial factors appear to be of importance in the transition of acute to chronic LBP. The aim of this study was to compare the cost-effectiveness of an intervention aimed at psychosocial factors to usual care in patients with (sub)acute LBP.

Minimally important change determined by a visual method integrating an anchor-based and a distribution-based approach.

Background: Minimally important changes (MIC) in scores help interpret results from health status instruments. Various distribution-based and anchor-based approaches have been proposed to assess MIC.

Objectives: To describe and apply a visual method, called the anchor-based MIC distribution method, which integrates both approaches.

Minimal clinically important change for pain intensity, functional status, and general health status in patients with nonspecific low back pain.

Study Design: Cohort study.

Objectives: To estimate the Minimal Clinically Important Change (MCIC) of the pain intensity numerical rating scale (PI-NRS), the Quebec Back Pain Disability Scale (QBPDS), and the Euroqol (EQ) in patients with low back pain.

Summary Of Background Data: MCIC can provide valuable information for researchers, healthcare providers, and policymakers.

Economic evaluations: a new avenue of outcome assessment in spinal disorders.

The number of economic evaluations in the field of spinal disorders and methodological studies have increased in the last decade. The objective of this paper is to provide an overview of current views on economic evaluations in the field of spinal disorders and to facilitate clinicians to interpret and use results from these studies. A full economic evaluation compares both costs and effects of two or more interventions.

Direct medical costs of traumatic thoracolumbar spine fractures.

Background: The costs and cost-effectiveness of treatment of thoracolumbar fractures are poorly known.

Methods: We estimated the costs of hospital care and outpatient visits for patients with traumatic thoracolumbar spine fractures.

Results: Stable fractures without neurological deficits were treated nonoperatively and the costs were EUR 5,100.

What is the most cost-effective treatment for patients with low back pain? A systematic review.

Economic evaluations of the various interventions available for low back pain will help clinicians and policymakers to identify the most beneficial treatment. This chapter aims to evaluate the most cost-effective treatments for patients with non-specific low back pain. Pubmed, Embase and the Cochrane library were used to search for articles published from 1966 to July 2004 using a variety of keywords.

Management of traumatic thoracolumbar fractures: a systematic review of the literature.

The management of unstable traumatic thoracolumbar fractures without neurological deficits remains controversial. The objective of this study was to compare the effectiveness of operative and conservative treatment of unstable traumatic thoracolumbar fractures. PubMed was used to search for articles published from January 1992 to January 2003 using a variety of keywords.

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649].

Background: Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably.

Methods: In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study.

Cost-effectiveness of hip protectors in frail institutionalized elderly.

A randomized controlled trial was performed to examine the cost-effectiveness of external hip protectors in the prevention of hip fractures. Since the hip protectors were not effective in preventing hip fractures in our study, the main objective became to examine whether the use of hip protectors results in lower average costs per participant in the hip protector group as compared with the control group. In addition, the average costs of a hip fracture and subsequent rehabilitation in frail, institutionalized elderly were calculated.