Low back pain in Australian adults: The economic burden
Walker, B.F., Muller, R. and Grant, W. (2003) Low back pain in Australian adults: The economic burden. In: Annual Scientific Conference. Spine Society of Australia 2003, 25 - 27 April 2003, Canberra, A.C.T.
INTRODUCTION: Low back pain (LBP) is a common symptom in Australian adults. In any six months period approximately 10% of Australian adults suffer some significant disability from low back pain1 • One way of assessing the impact ofLBP on a population is to estimate the economic costs associated with the disorder. This method is usually known as a "Cost-of-Illness" or an "Economic Burden" studl. The economic burden of disease is often divided into direct and indirect costs and is most often calculated using the Human Capital Method2 • According to this method the direct costs are represented by the dollar value of the interventions required for diagnosis, treatment and rehabilitation of the disease and the indirect costs by valuing the loss of productivity due to morbidity and mortality2 • 3 • We estimated the economic burden ofLBP in Australian adults.
METHODS: Data sources used in this study were the 2001 Australian adult low back pain prevalence survey1 and a multiplicity of Commonwealth, State and Private Health instrumentalities. Using the Human Capital Method direct costs were estimated on the basis of market prices (charges) and the indirect costs by valuing the loss of productivity due to morbidity. The conservative Friction Cost Method for calculating indirect costs was also used as a comparison4 • A sensitivity analysis was undertaken where unit prices and volume for a range of services were varied over a feasible range (10%) to review the consequent change in overall costs.
RESULTS: We estimated the direct cost oflow back pain in 2001 to be AUD$1.02 Billion. Approximately 71% of this amount is for treatment by chiropractors, general practitioners, massage therapists, physiotherapists and acupuncture. However, the direct costs are minor compared to the indirect costs of AUD$8.15 Billion giving a total cost of A UD$9 .17 Billion. The sensitivity analysis showed very little change in results.
DISCUSSION: The economic burden oflow back pain in Australian adults represents a massive health problem. This burden is so great that it has compelling and urgent ramifications for health policy, planning and research. This study identifies that research should concentrate on the reduction of indirect costs. This is not to suggest excluding direct cost research, as it is likely that early, efficient and evidence-based management oflow back pain in the first instance may lessen the indirect costs that often follow. These startling results advocate urgent Government attention to LBP as a disorder.
REFERENCES: 1. Walker, B.F. The prevalence of low back pain and related disability in Australian adults. Data from a population survey of3000 Australians selected at random in 2001. Paper under review.
2. Hodgson, T.A. and Meiners, M.R. Cost-of-Illness methodology: a guide to current practices and procedures, Milbank Memorial Fund Quarterly/Health and Society, 1982;60:429-462.
3. Rice,DP (1966): Estimating the Cost ofllness. Health Economics Series, Number 6. DREW, Public Health Service, Division of Medical Care Administration, Health Economics Branch, Washington, DC, 20201 USA.
4. Koopmanschap,MA; Rutten,FFH. A practical guide for calculating indirect costs of disease.
Pharmaco-Economics 1996,1 0:460-466.
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