Manchikanti, LaxmaiahPampati, VidyasagarKaye, Alan D.Hirsch, Joshua2018-02-262018Manchikanti, Laxmaiah, Vidyasagar Pampati, Alan D. Kaye, and Joshua A. Hirsch. 2018. “Therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain: cost utility analysis based on a randomized controlled trial.” The Korean Journal of Pain 31 (1): 27-38. doi:10.3344/kjp.2018.31.1.27. http://dx.doi.org/10.3344/kjp.2018.31.1.27.http://nrs.harvard.edu/urn-3:HUL.InstRepos:34868851Background: Related to escalating health care costs and the questionable effectiveness of multiple interventions including lumbar facet joint interventions, cost effectiveness or cost utility analysis has become the cornerstone of evidence-based medicine influencing coverage decisions. Methods: Cost utility of therapeutic lumbar facet joint nerve blocks in managing chronic low back pain was performed utilizing data from a randomized, double-blind, controlled trial with a 2-year follow-up, with direct payment data from 2016. Based on the data from surgical interventions, utilizing the lowest proportion of direct procedural costs of 60%, total cost utility per quality adjusted life year (QALY) was determined by multiplying the derived direct cost at 1.67. Results: Patients in this trial on average received 5.6 ± 2.6 procedures over a period of 2 years, with average relief over a period of 2 years of 82.8 ± 29.6 weeks with 19 ± 18.77 weeks of improvement per procedure. Procedural cost for one-year improvement in quality of life showed USD $2,654.08. Estimated total costs, including indirect costs and drugs with multiplication of direct costs at 1.67, showed a cost of USD $4,432 per QALY. Conclusions: The analysis of therapeutic lumbar facet joint nerve blocks in the treatment of chronic low back pain shows clinical effectiveness and cost utility at USD $2,654.08 for the direct costs of the procedures, and USD $4,432 for the estimated overall cost per one year of QALY, in chronic persistent low back pain non-responsive to conservative management.en-USCost-benefit analysisCost effectivenessDiagnostic techniques and proceduresLow back painLumbar vertebraeNerve blockQuality-adjusted life years (QALY)Randomized controlled trialTherapeutic usesZygapophyseal jointJournal Article2018-02-2610.3344/kjp.2018.31.1.27