Treating chronic low back pain with approaches such as yoga and talk therapy is cost effective, the Institute for Clinical and Economic Review announced this month. Will health plans respond by expanding coverage for non-pharmacologic therapies?
The Institute for Clinical and Economic Review, or ICER, is a drug price watchdog group that calculates benchmark prices based upon treatments’ cost effectiveness and budget impact. Recent ICER reports have analyzed treatments for rheumatoid arthritis, chronic pain and other conditions. The reports often call for drastic price reductions on innovative drugs, providing justification for health plans to limit coverage.
This report instead takes a cautiously optimistic tone.
“Evidence on therapies such as acupuncture, [cognitive behavioral therapy], mindfulness-based stress reduction, and yoga suggest that they may offer benefit to appropriate patients with chronic back pain,” explained ICER’s Chief Medical Officer David Rind, MD.
ICER’s analysis found that mind-body techniques and talk therapy produce health outcomes that are “comparable to or better” than usual care – that is, pain management education, oral pain medications such as NSAIDs, or physical therapy.
The finding squares with balanced pain management, a multi-prong approach that has gained traction in recent years. As defined by the Alliance for Balanced Pain Management, the approach “better alleviates pain by giving people access to the full range of effective treatment strategies.” The alliance defines these strategies as both pharmacologic and non-pharmacologic.
The challenge is cost. As ICER acknowledges, adding non-pharmacologic therapies generates higher treatment costs.
Some health plans currently have more favorable coverage for generic opioid pain pills, leading patients to choose the less expensive, more immediate way to manage pain. But America’s opioid crisis shows that patients, their families and their communities need other options.
To learn more about the role of non-pharmacologic treatments for pain, watch “Understanding Balanced Pain Management.”