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The economic and humanistic costs of chronic lower back pain in Japan

Authors Montgomery W, Sato M, Nagasaka Y, Vietri J

Received 28 February 2017

Accepted for publication 11 May 2017

Published 23 June 2017 Volume 2017:9 Pages 361—371


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Lorenzo Colombo

William Montgomery,1 Masayo Sato,2 Yasuo Nagasaka,2 Jeffrey Vietri3

1Global Patient Outcomes & Real World Evidence, Eli Lilly Australia Pty Ltd., West Ryde, Australia; 2Medical Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan; 3Kantar Health, Horsham, PA, USA

Background: Few data are available that provide estimates of the economic impact of chronic lower back pain (CLBP) in Japan. The current study estimated the patient burden and the direct and indirect medical costs associated with CLBP in Japan using data from a large cross-sectional patient survey. CLBP was hypothesized to be associated with a considerable burden of illness and a large economic impact.
Methods: Study participants completed the Japan National Health and Wellness Survey in 2014, which included measures of health-related quality of life (HRQoL), work impairment, impairment to daily activities, and healthcare service use. Data from those reporting CLBP (N=392) were contrasted against those from matched controls without back pain, using age and sex-adjusted models.
Results: CLBP patients reported significantly lower HRQoL relative to matched controls. Age- and sex-adjusted models estimated mean annual per patient direct and indirect costs attributable to CLBP to be ¥1,820,297 ($15,239 or €12,551) and ¥1,479,899 ($12,389 or €10,203), respectively, with the majority of direct costs related to hospital expenses (¥1,584,759, which is equivalent to $13,267 and €10,927). In estimating the economic impact of CLBP on society, the CLBP respondents were estimated to include 1,508,524 individuals when extrapolated to the Japanese population (815,461 of them employed). Ultimately, this represented approximately ¥1.2 trillion ($10 billion and €8.3 billion) per year in lost productivity at the time of this study.
Conclusion: This study of patients with CLBP in Japan has shown it to be associated with a significant burden on patients and to have a considerable negative impact on the Japanese economy primarily driven by lost productivity. Further research on the effectiveness of interventions to improve the outcomes of those with CLBP is warranted.

Keywords: indirect costs, direct costs, work impairment, healthcare resource use, quality of life

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