Introduction of the Issue
Any illness brings with it an associated cost that is incurred by the patient. The economic burden resulting from Low Back Pain (LBP) has currently been on an upward trend. The issue being debated about is the most preferred process of estimation for indirect costs. The issue arises when determining what perspective of the cost is to be used to value the cost of LBP. The tug of war is between the friction approach and the human capital approach. Understanding both the strengths and weakness of the burden will help in developing the solution to this issue. In spite of the current advancement in technology in diagnosis and introduction of intervention, the socioeconomic burden is still increasing. Estimation of the cost of chronic low back pain illness is a matter of discussion by various stakeholders in the health industry. The issue can be well summarized through analysis of the cost of illness. The study of cost of illness has the purpose of giving a summary of the economic burden resulting from the illness. It should be noted that this is different from the health economic evaluations. The purpose of this evaluation is not estimation of cost but rather evaluation of the cost incurred in introducing interventions.
Justification of the Importance
A number of studies have been carried out in an effort to provide an estimation of various costs attributed to LBP. The costs creating the economic burden are allocated amongst different categories. The categories include direct costs, indirect costs and incremental costs. Estimates of these costs are based on the cost perspective employed by a researcher. Comparisons made between estimates of cost of illness from different countries indicate huge differential margins. This is a result of various studies using different perspectives of costs. All these economic burden studies estimates have not been able to provide correct estimates that represent the societal perspective. The perspective from society is that the interventions might be cost savings while researchers have different opinions. This study will give a clear explanation on the socioeconomic burden brought about by LBP.
Alternative perspectives
About eighteen studies have provided estimates for indirect costs. These studies have categorised the indirect costs into sick leave, early retirement, house productivity loss, presenteeism, and inactivity. These studies used the human capital approach to estimate indirect costs with the exception of one which employed friction approach. Hutubessy et al. using the human capital approach estimated losses from work productivity at $4.6 billion. Maniadakis and Gray study in UK shows a work productivity losses estimated at £9.1 billion. The loss in Australia is estimated at AUD$ 8.1 billion as indicated by Walker et al. who uses the friction approach. These studies treat costs differently.
My position
The human capital approach seems to be mostly preferred by many researchers as the best perspective of costs. I believe that it should be used as the basis of estimating the economic burden of low back pain. It takes into consideration the bearer of the burden. Using the societal perspective can accommodate the patient, employer, insurer and the government perspective in this matter.
Implications
Use of a single approach in cost estimation will create room for comparisons between studies and data from different countries. It will provide a platform where the various stakeholders of the health sector can mingle and provide viable solutions. This approach presents an opportunity of cost saving through the use of interventions from a societal perspective.
References
Dagenais, S., Caro, J., & Haldeman, S. (2008). A systematic review of low back pain cost of illness studies. The Spine Journal, 8-20.
