# Economic Evaluation of Pharmacopuncture for Adhesive Capsulitis Alongside a Pilot Pragmatic Randomized Controlled Trial Comparing Pharmacopuncture and Physical Therapy

## TL;DR

This study compares the cost-effectiveness of pharmacopuncture and physical therapy for treating adhesive capsulitis, finding pharmacopuncture to be more cost-effective.

## Contribution

The study provides new evidence on the cost-effectiveness of pharmacopuncture compared to physical therapy for adhesive capsulitis.

## Key findings

- Pharmacopuncture had lower societal costs and higher medical costs compared to physical therapy.
- Pharmacopuncture was dominant from the societal perspective and had favorable incremental cost-effectiveness ratios.
- The study confirmed the feasibility of a full-scale trial on pharmacopuncture for adhesive capsulitis.

## Abstract

Background/Objectives: Pharmacopuncture and physical therapy are commonly used to treat adhesive capsulitis (AC); however, their comparative cost-effectiveness is unclear. In this study, we aimed to investigate their cost-effectiveness for patients with AC. Methods: We conducted an economic evaluation alongside a 12-week, multicenter, pragmatic randomized controlled trial in four Korean medicine hospitals in South Korea. Patients with limited range of motion and pain score (numeric rating scale score ≥ 5) were randomized into a pharmacopuncture therapy or physical therapy group at a ratio of 1:1. Interventions were administered twice weekly for 6 weeks, with a follow-up of up to 12 weeks. Quality-adjusted life years were calculated using the EuroQol-5 Dimension 5 Level (EQ-5D-5L) and Short Form-6 dimension. Costs from societal and healthcare system perspectives were analyzed. Results: In total, 50 participants (pharmacopuncture therapy: 24; physical therapy: 26) were included. The differences in quality-adjusted life years between the groups were 0.014 and 0.013 when calculated using the EQ-5D-5L and Short Form-6-dimension scores, respectively. The costs from the societal perspective were significantly lower, whereas medical costs were higher, in the pharmacopuncture therapy group. Pharmacopuncture was the dominant treatment from the societal perspective. From the healthcare system perspective, the incremental cost-effectiveness ratios of pharmacopuncture to physical therapy were $4386 and $4790 when calculated using the EQ-5D-5L and Short Form-6-dimension scores, respectively. Sensitivity analyses confirmed the results. Conclusions: Pharmacopuncture therapy is more cost-effective for patients with AC than physical therapy. In this pilot study, pharmacopuncture may represent a potentially cost-effective treatment compared with physical therapy for patients with adhesive capsulitis, and the feasibility of conducting a full-scale study was confirmed.