TY - JOUR
T1 - Management of low back pain in the Brazilian public health system
T2 - budget impact analysis of the implementation of Pilates exercises compared to usual care
AU - Carregaro, Rodrigo Luiz
AU - Jornada Ben, Ângela
AU - de Toledo, Aline Martins
AU - Marques, Yara Andrade
AU - Tottoli, Caroline Ribeiro
AU - Ostelo, Raymond
AU - Peixoto, Henry Maia
AU - Bosmans, Judith E
PY - 2026
Y1 - 2026
N2 - 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.
AB - 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.
KW - Back pain
KW - economic evaluation
KW - physiotherapy
KW - rehabilitation
U2 - 10.1080/14737167.2025.2583182
DO - 10.1080/14737167.2025.2583182
M3 - Article
C2 - 41171618
SN - 1473-7167
VL - 26
SP - 1
EP - 9
JO - Expert review of pharmacoeconomics & outcomes research
JF - Expert review of pharmacoeconomics & outcomes research
IS - 1
ER -