Are anti-inflammatory drugs really the cheaper option?

(NSAID=Non steroidal anti-inflammatory drug, AKA over the counter pain relievers)

In regards to non-surgical spinal care, there are two main views that contrast each other. One is for the use of NSAIDS, or over the counter pain relievers, and the other is for the use of chiropractic care to treat back pain. What treatment a patient uses is usually based on who they go to first with back pain. Primary care physicians will mostly prescribe NSAIDs and chiropractors will prescribe spinal adjustments. This debate is primarily centered on overall outcome and cost effectiveness as well as safety.

There is a preconceived notion that NSAIDS are more cost effective than chiropractic care and if you compare costs at a surface level as most cost comparison studies do, then yes, NSAIDs may be cheaper. However, very few cost comparison studies looked at the whole picture, which should also factor in total treatment costs, disease and pain prevention, and medical complications.  

One study by Rahme, et al, looked at this cost impact specifically due to gastrointestinal (GI) complications associated with NSAID use as NSAIDs can cause an upset stomach and even bleeding ulcers in your GI tract. Treating these kinds of complications is so common with medication that it is universally known as the “shadow cost”, because it is often unaddressed when looking at treatment costs.

The authors of the study concluded that using NSAIDs may actually cost you double the initial cost because of Gastrointestinal tract complications. But this does not factor in renal complications that are common with NSAID use and complications from Congestive Heart Failure (CHF) which actually exceed the costs of GI complications. From the likelihood and cost of GI, renal, and cardiovascular complications, NSAIDs could cost up to 6 times as much as the original price of the prescription, proving that the true cost of this form of treatment is in no way cheaper than the alternative chiropractic care.