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The STAR (steroids against radiculopathy)-trial aimed to evaluate the (cost-) effectiveness of TESI in patients with acute sciatica (&lt;\u20098\u2009weeks). This article contains the economic evaluation of the STAR-trial.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Participants were randomized to one of three study arms: Usual Care (UC), that is oral pain medication with or without physiotherapy, <jats:italic>n<\/jats:italic>\u2009=\u200945); intervention group 1: UC and transforaminal epidural steroid injection (TESI) 1\u2009ml of 0.5% Levobupivacaine and 1\u2009ml of 40\u2009mg\/ml Methylprednisolone and intervention group 2: UC and transforaminal epidural injection (TEI) with 1\u2009ml of 0,5% Levobupivacaine and 1\u2009ml of 0.9% NaCl (<jats:italic>n<\/jats:italic>\u2009=\u200950). The primary effect measure was health-related quality of life. Secondary outcomes were pain, functioning, and recovery. Costs were measured from a societal perspective, meaning that all costs were included, irrespective of who paid or benefited. Missing data were imputed using multiple imputation, and bootstrapping was used to estimate statistical uncertainty.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>None of the between-group differences in effects were statistically significant for any of the outcomes (QALY, back pain, leg pain, functioning, and global perceived effect) at the 26-weeks follow-up. The adjusted mean difference in total societal costs was \u20ac1718 (95% confidence interval [CI]: \u2212\u20093020 to 6052) for comparison 1 (intervention group 1 versus usual care), \u20ac1640 (95%CI: \u2212\u20093354 to 6106) for comparison 2 (intervention group 1 versus intervention group 2), and \u20ac770 (95%CI: \u2212\u20093758 to 5702) for comparison 3 (intervention group 2 versus usual care). Except for the intervention costs, none of the aggregate and disaggregate cost differences were statistically significant. The maximum probability of all interventions being cost-effective compared to the control was low (&lt;\u20090.7) for all effect measures.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>These results suggest that adding TESI (or TEI) to usual care is not cost-effective compared to usual care in patients with acute sciatica (&lt;\u20098\u2009weeks) from a societal perspective in a Dutch healthcare setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>Dutch National trial register: NTR4457 (March, 6th, 2014).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12891-024-07366-5","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T09:12:43Z","timestamp":1711962763000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost-effectiveness of Transforaminal epidural steroid injections for patients with ACUTE sciatica: a randomized controlled trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Bastiaan C.","family":"ter Meulen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther T.","family":"Maas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rien","family":"van der Vegt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Haumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry C.","family":"Weinstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond W. 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