Cost-effectiveness of adding psychomotor therapy to a multidisciplinary rehabilitation program for chronic pain

  • Lia van der Maas Human Movement and Education Division, University of Applied Sciences Windesheim, Zwolle and Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam - The Netherlands
  • Judith E. Bosmans Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam - The Netherlands
  • Maurits W. van Tulder Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam - The Netherlands
  • Thomas W.J. Janssen Reade, Amsterdam Rehabilitation Research Center, Amsterdam and Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam - The Netherlands
Keywords: Chronic pain, Cost-effectiveness, Multidisciplinary rehabilitation, Psychomotor therapy


Introduction: This study assesses the cost-effectiveness (CE) of a multidisciplinary pain rehabilitation program (treatment as usual [TAU]) with and without psychomotor therapy (PMT) for chronic pain patients.

Methods: Chronic pain patients were assigned to TAU + PMT or TAU using cluster randomization. Clinical outcomes measured were health-related quality of life (HRQOL), pain-related disability, and quality-adjusted life years (QALYs). Costs were measured from a societal perspective. Multiple imputation was used for missing data. Uncertainty surrounding incremental CE ratios was estimated using bootstrapping and presented in CE planes and CE acceptability curves.

Results: Ninety-four chronic pain patients (n = 49 TAU + PMT and n = 45 TAU) were included. There were no significant differences in HRQOL, Pain Disability Index, and QALYs between TAU + PMT and TAU. Direct costs in TAU + PMT were significantly higher than in TAU (mean difference €3327, 95% confidence interval [CI] 1329; 5506). However, total societal costs in TAU + PMT were not significantly higher than in TAU (mean difference €642, 95% CI −3323; 4373). CE analyses showed that TAU + PMT was not cost-effective in comparison with TAU.

Conclusions: Adding PMT to a multidisciplinary pain rehabilitation program is not considered cost-effective in comparison with a multidisciplinary pain rehabilitation program alone. The results of this study should be interpreted with caution because of the small sample size and high drop-out rate.


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How to Cite
van der Maas L, Bosmans J, van Tulder M, Janssen T. Cost-effectiveness of adding psychomotor therapy to a multidisciplinary rehabilitation program for chronic pain. GRHTA [Internet]. 14Dec.2020 [cited 22Jan.2021];7(1):124-30. Available from:
Mental Health Economics: the Netherlands experience