Principles of economic evaluation for interventions of chronic musculoskeletal pain

Economic evaluation is attracting increasing attention to inform policy makers, insurers and other payers of the value of existing and new treatment modalities. Hence, it is desirable to assess not only the medical but also the economic consequences the new treatments produce. The available literature on economic evaluation revealed an urgent need for sound economic evaluation studies in the field of chronic musculoskeletal pain. Due to the generally weak methodology, the intended purpose of economic evaluation to help set funding priorities has often been bypassed. Although in general therapists have no direct responsibility for allocating scarce resources in the field of musculoskeletal pain, they are confronted with the results of these decisions in their everyday work. A clear understanding of the main principles of economic evaluation studies might therefore be advantageous. This paper addresses important methodological issues in economic evaluation research, such as the techniques for economic evaluation studies and the analytic perspective. In addition, the paper pays attention to the inclusion of costs and outcomes in economic evaluation research, sensitivity analysis, discounting, incremental analysis and ratios, and collecting of data. Further emphasis is placed on the transparent reporting of methods and study results. A clear reporting may help therapists and other researchers interpret the results of published studies and apply them to their own studies, and it may help decision makers generalize results from one setting to another.