An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: a randomized trial (ATLAS)

PLOS One 2017;12:e0178918. doi: 10.1371/journal.pone.0178918

Essex H, Parrott S, Atkin K, Ballard K, Bland M, Eldred J, Hewitt C, Hopton A, Keding A, Lansdown H, Richmond S, Tilbrook H, Torgerson D, Watt I, Wenham A, Woodman J, MacPherson H


This analysis calculated the cost-effectiveness of the series of Alexander lessons and acupuncture sessions provided in the ATLAS trial. It suggests that Alexander lessons are less likely than acupuncture to be cost effective for people with chronic neck pain, with the main reason being that they cost more to deliver. The greater delivery cost was because there were 20 Alexander lessons offered to participants in the trial but 12 acupuncture sessions (although the overall intervention time was exactly the same for both, at 600 minutes). One-to-one Alexander lessons are attention-intensive, with the teacher present and fully engaged for the whole lesson. The analysis suffered from high levels of missing economic data which made the conclusions uncertain.


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Kathy Glenn

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