Comment on the article “Comparison of the Cost-Utility Analysis of Electroacupuncture and Nonsteroidal Antiinflammatory Drugs in the Treatment of Chronic Low Back Pain”

摘要

Toroski et al in their study, Comparison of the CostUtility Analysis of Electroacupuncture and Nonsteroidal Antiinflammatory Drugs in the Treatment of Chronic Low Back Pain, identifies a gap in the pharmacoeconomic literature regarding the treatment of chronic low back pain. There is evidence to demonstrate that traditional acupuncture is efficacious in the treatment of chronic low back pain; however, there are no studies comparing the effectiveness of electroacupuncture to other standards of care, such as nonsteroidal antiinflammatory drugs (NSAIDs).1,2 Although this study aimed to answer a novel and relevant question, there are several limitations that prevent the study results from being generalizable and ultimately applicable to therapeutic decision-making. First, there is no description of the comparator. It is important to explain why NSAIDs were chosen as the comparator and what types and dosing schedules of NSAIDs were studied. Without this information, it is difficult to evaluate the true cost and effectiveness of NSAIDs. Second, the costs presented in the study are not transparent. It is challenging to analyze the specific costs, especially the direct nonmedical costs because they are not specified. Third, the study failed to present the results in the appropriate format; costeutility analyses require results in terms of qualityadjusted life years and incremental costeutility ratios. However, only utilities and average cost-effectiveness ratios were reported in the study.