Indirect costs of back pain – Review

IntroductionBack pain is a major health problem and a leading cause of disability. It generates work absenteeism and great costs for the society.AimThe objective of this study is to review the literature on indirect costs of back pain and determine the amount of indirect costs among total costs.Material and methodsMedline, Embase and Polish Medical Bibliography (PBL) databases were searched to identify studies about indirect costs of back pain published up to April 2013 with no country specific limitation. After screening of 210 titles and abstracts, chosen full-text papers were reviewed. Finally 13 articles met the inclusion criteria. Relevant characteristics were extracted and summarized.Results and discussionThe data presented in reviewed studies referred to USA, Netherlands, Sweden, Australia, Germany, UK, and Switzerland but no dedicated analysis for Poland was identified. All studies were conducted from societal perspective. Mainly, the Human Capital Approach was used to assess indirect costs. One study was based on Friction Costs Method and four studies compared both methods. Few studies included presenteeism as a result of lost productivity. Indirect costs comprised 27.4%–95% of total costs.ConclusionsIndirect costs composed a significant part of the total costs of back pain and should be taken into consideration in cost-of-illness analysis. The differences in indirect costs resulted from various methodologies. There is a need to elaborate uniform and generally accepted methodology for indirect costs assessment. As no social burden of back pain was calculated in Poland, there is a need for further research especially on indirect cost.