This report evaluates the one-year cost-effectiveness of adding standard acupuncture (SA) or enhanced acupuncture (EA) to usual medical care (UMC) for older adults with chronic low back pain (CLBP), from healthcare sector and Medicare perspectives. CLBP is prevalent among older populations and incurs high costs, often due to non-guideline-concordant treatments. While acupuncture has demonstrated effectiveness and cost-efficiency for CLBP, studies focusing specifically on older adults are limited.
The analysis utilized data from a randomized trial across three U.S. health systems. Cost-utility and cost-effectiveness assessments compared outcomes for participants receiving SA, EA, or UMC alone. Bootstrap techniques generated 95% confidence intervals for the estimates.
Results indicated that EA (n=225) significantly reduced healthcare costs by approximately $491 per participant and Medicare costs by about $421, compared to UMC alone. These reductions were accompanied by meaningful health benefits, including an increase of 0.037 in quality-adjusted life-years (QALYs) and an 18.5% higher proportion of participants achieving a clinically meaningful improvement (CMI) in disability scores. Conversely, SA (n=222) was more costly than UMC, with an incremental cost-effectiveness ratio of approximately $52,897 per QALY gained. However, the QALY gains (0.014) and improvements in disability (6.9%) for SA versus UMC were not statistically significant.
In conclusion, enhanced acupuncture appears to be a cost-saving intervention that improves health outcomes among older adults with CLBP across multiple healthcare systems. Standard acupuncture, while more expensive than UMC, may still be considered cost-effective, though its benefits were not statistically significant. These findings support the integration of EA into treatment plans for older patients with CLBP to optimize health benefits and reduce costs within the healthcare system.
Reference:
Herman PM, Mann S, DeBar LL, Avins AL, Justice M, Nielsen A, Pressman A, Stone KL, Wellman R, Cook AJ. Cost-Effectiveness of Acupuncture Needling for Older Adults With Chronic Low Back Pain. Spine (Phila Pa 1976). 2026 Feb 1;51(3):E65-E75. doi: 10.1097/BRS.0000000000005549. Epub 2025 Oct 29. PMID: 41493335; PMCID: PMC12778958.
