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The Trend in Total Cost of Back Pain in the Netherlands in the Period 2002 to 2007

Lambeek, Ludeke C. PhD*,†; van Tulder, Maurits W. MD; Swinkels, Ilse C.S. PhD§; Koppes, Lando L.J. PhD; Anema, Johannes R. MD, PhD*,†,∥; van Mechelen, Willlem MD, PhD*,†,∥

doi: 10.1097/BRS.0b013e3181e70488
Health Services Research
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Study Design. Cost of illness study.

Objective. To investigate the total costs of back pain in the Netherlands over the years 2002 to 2007.

Summary of Background Data. In 1991, the cost of back pain to the Dutch society was estimated at €4.2 billion. In the last two decades, new laws regarding health insurance and sickness benefits and new guidelines for health care professionals have been introduced and may have affected the societal costs of back pain in the Netherlands.

Methods. We conducted a cost-of-illness study in which we gathered relevant available data from national registries, reports of research institutes, descriptive studies, and occupational health care authorities to estimate the total cost of back pain to the Dutch society for the years 2002 to 2007.

Results. The total costs of back pain decreased from €4.3 billion in 2002 to €3.5 billion in 2007. The share of these costs was about 0.9% of the gross national product (GNP) in 2002 and 0.6% of GNP in 2007. The ratio between direct and indirect costs did not change noticeably over the years, that is, 12% for direct and 88% for indirect costs.

Conclusions. The total societal costs of back pain have decreased since 1991 and also between 2002 and 2007. Although Dutch policy interventions to lower the indirect costs seem to be successful in the last decades, costs of back pain are still substantial, and indirect costs represent the majority of these costs. Policy interventions and implementation of cost-effective interventions focusing on return-to-work management for back pain in health care is important to further decrease the economic burden of back pain on society.

Supplemental Digital Content is Available in the Text.The costs of back pain to the Dutch society have been decreased over the years. Dutch policy interventions to lower the indirect costs seem to be successful in the last decades; still costs of back pain are substantial and indirect costs represent the majority of these costs.

* EMGO Institute for Health and Care Research, Department of Public and Occupational Health, VU University Medical Center, Amsterdam, the Netherlands;

Research Center Physical Activity, Work and Health, TNO-VU-University Medical Center, Amsterdam, the Netherlands;

Department of Health Sciences and EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands;

§ NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands;

Division of Work and Employment, TNO Quality of Life, Hoofddorp, the Netherlands;

Research Center for Insurance Medicine AMC-UWV-VU University Medical Center, Amsterdam, the Netherlands.

Address correspondence and reprint requests to Johannes R. Anema, MD, PhD, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherland; E-mail: E:h.anema@vumc.nl

Supplemental digital content is available for this article. Direct URL citations appearing in the printed text are provided in the HTML and PDF version of this article on the journal's web file (www.spinejournal.com).

Acknowledgment date: April 20, 2010. Acceptance date: May 10, 2010.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Supported by VU University Medical Center, TNO Work & Employment, Dutch Health Insurance Executive Council (CVZ), Stichting Instituut GAK (SIG), and the Netherlands Organization for Health Research and Development (ZonMw). The funders had no role in the project.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

© 2011 Lippincott Williams & Wilkins, Inc.