Comparative Cost Analysis of Neck Pain Treatments for Medicare Beneficiaries.
Brian R Anderson, Todd A MacKenzie, Leah M Grout and 1 others
PMID 39955668WHAT IT FOUND
Among older adults with new neck pain, starting with chiropractic spinal manipulation was associated with lower Medicare costs than primary care without analgesics in some claims, but not all.
Key findings
01Chiropractic spinal manipulation was associated with lower total Medicare Part A and Part B costs than primary care without analgesics.
02For neck pain-related Part B claims, the manipulation cohort had lower costs, while the manipulation cohort showed no significant difference for neck pain-related Part A costs.
03Analgesic medication costs were lower in the manipulation cohort, and the primary care analgesic cohort also showed lower analgesic medication costs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was observational, so treatment selection may explain some cost differences even after weighting. Neck pain severity and disability were not measured, so cost savings do not show better or worse clinical outcomes. Medicare Advantage enrollees were excluded, so results may not apply to all older adults with Medicare. Non-prescription medication use was not captured, and prior neck pain episodes could not be fully ruled out. The paper did not evaluate physical therapy or other non-surgical interventions. Some statistically significant differences were small in dollar terms.
Declared interests
The authors declared no competing interests and approved the manuscript. The paper is listed as supported by NIH extramural funding.
The easy way to misread this
Do not read the lower costs as proof that chiropractic spinal manipulation is clinically better than primary care. The study did not measure neck pain severity, disability, or physical therapy, and several cost differences were small or inconsistent.