Work

Management of low back pain in the Brazilian public health system: budget impact analysis of the implementation of Pilates exercises compared to usual care

Year: 2025

Type: article

Abstract: BACKGROUND: Low back pain (LBP) is a disabling condition affecting all age groups globally. Exercise is safe and cost-effective for managing LBP. Pilates is an effective exercise modality recommended for LBP but is not reimbursed by the Brazilian Public Health System. This study aimed to estimate the budget impact of implementing Pilates for LBP patients within the Brazilian public health system compared to usual care. RESEARCH DESIGN AND METHODS: A budget impact analysis (BIA) was conducted over a five-year horizon, from healthcare and societal perspectives. Costs were extracted in local currency and converted to international dollars using purchasing power parities. Deterministic sensitivity analyses were performed. RESULTS: Over five years, healthcare costs in the usual care were Int$860.8 million, while Pilates reached Int$958 million, resulting in an incremental impact of Int$97.2 million. From the societal perspective, the usual care cost was Int$4.32 billion, and the Pilates scenario was Int$4.15 billion, indicating savings of Int$172.2 million. The incremental budget impact was negative, meaning that Pilates would provide savings of Int$172,203,216. CONCLUSION: Implementing a group-based Pilates program for LBP in the Brazilian public health system would increase healthcare costs by Int$97 million but generate societal savings of Int$172 million over five years.

Source: Expert Review of Pharmacoeconomics & Outcomes Research

DOI: 10.1080/14737167.2025.2583182