CRJCapt: I'm not sure why you think a back course approach is any more difficult than a localiser approach, True, a pilot executing a BC approach has to be able to walk and chew gum at the same time but any competent IFR pilot should have no difficulty at all with a BC.
As noted above, one disadvantage is that most BCA's produce reverse sensing on the VOR, HSI, etc. That should only be a problem for a pilot in his/her initial training stages. The other disadvantage, not noted above, is the minimum descent altittude for a BCA is normally higher than for an ILS. In marginal weather, that can sometimes make the difference in completing the approach or having to execute a miss approach and go to an alternate.
Having flown dozens, possibly hundreds of BCA's without the aid of an autopilot, I can assure you it is not a difficult approach to fly well. I'd much rather fly a BCA than an ADF approach, any day.