Cost-effectiveness of Mindfulness-based Stress Reduction Versus Cognitive Behavioral Therapy or Usual Care Among Adults With Chronic Low Back Pain.
Patricia M. Herman, Melissa L Anderson, Karen J Sherman, Benjamin H Balderson, Judith A Turner, Daniel C Cherkin
Spine October 15, 2017 DOI: 10.1097/brs.0000000000002344 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Economic evaluation alongside a randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 342 |
| Population | Adults with chronic low back pain in an integrated healthcare system |
| Interventions | Cognitive-behavioral therapy (CBT) Mindfulness-based stress reduction (MBSR) |
| Duration | 8-weekly 2-hour group sessions; 1-year follow-up |
| Measures | Quality-adjusted life-years (QALYs) |
| Topics | Meditation |
| Key findings | Compared with usual care, MBSR saved an average of $724 per participant from a societal perspective while CBT cost $125 more, and both produced statistically significant QALY gains (0.041 for CBT, 0.034 for MBSR). The authors conclude that CBT and MBSR have high probabilities of being cost-effective, and that MBSR may be cost saving. |
Abstract
Economic evaluation alongside a randomized trial of cognitive-behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) versus usual care alone (UC) for chronic low back pain (CLBP). To determine 1-year cost-effectiveness of CBT and MBSR compared to 33 UC. CLBP is expensive in terms of healthcare costs and lost productivity. Mind-body interventions have been found effective for back pain, but their cost-effectiveness is unexplored. A total of 342 adults in an integrated healthcare system with CLBP were randomized to receive MBSR (n = 116), CBT (n = 113), or UC (n = 113). CBT and MBSR were offered in 8-weekly 2-hour group sessions. Cost-effectiveness from the societal perspective was calculated as the incremental sum of healthcare costs and productivity losses over change in quality-adjusted life-years (QALYs). The payer perspective only included healthcare costs. This economic evaluation was limited to the 301 health plan members enrolled ≥180 days in the years pre-and postrandomization. Compared with UC, the mean incremental cost per participant to society of CBT was $125 (95% confidence interval, CI: -4103, 4307) and of MBSR was -$724 (CI: -4386, 2778)-that is, a net saving of $724. Incremental costs per participant to the health plan were $495 for CBT over UC and -$982 for MBSR, and incremental back-related costs per participant were $984 for CBT over UC and -$127 for MBSR. These costs (and cost savings) were associated with statistically significant gains in QALYs over UC: 0.041 (0.015, 0.067) for CBT and 0.034 (0.008, 0.060) for MBSR. In this setting CBT and MBSR have high probabilities of being cost-effective, and MBSR may be cost saving, as compared with UC for adults with CLBP. These findings suggest that MBSR, and to a lesser extent CBT, may provide cost-effective treatment for CLBP for payers and society. 2.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 25
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments Substance Abuse Treatment, Prevention, and Policy July 29, 2020
- Chatbot-Based Mindfulness-Based Stress Reduction Program for University Students With Depressive Symptoms: Intervention Development and Pilot Evaluation. Journal of the American Psychiatric Nurses Association 2025
- A Digital Music-Based Mindfulness Intervention for Black Americans With Elevated Race-Based Anxiety: A Multiple-Baseline Pilot Study. JMIR Formative Research August 16, 2023
- Immunomodulatory and behavioral effects of ayahuasca and N, N-dimethyltryptamine in a rat model of lipopolysaccharide-induced depression. Metabolic Brain Disease June 11, 2025
and 20 more in the library
Cites 3
- A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Internal Medicine March 1, 2016
- Mindfulness-based stress reduction for low back pain. A systematic review. BMC Complementary and Alternative Medicine September 25, 2012
- Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA