Highlights
- •Economic evaluations of psychological therapies are scant in fibromyalgia (FM).
- •This was a cost-utility report of acceptance and commitment therapy (ACT) in FM.
- •ACT was less costly and more effective than recommended drugs in FM.
- •The inclusion of lost productivity costs reduced the cost-utility of ACT in FM.
Abstract
The aim of this study was to analyze the cost utility of a group-based form of acceptance
and commitment therapy (GACT) in patients with fibromyalgia (FM) compared with patients
receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The
data were derived from a previously published study, a randomized controlled trial
that focused on clinical outcomes. Health economic outcomes included health-related
quality of life and health care use at baseline and at 6-month follow-up using the
EuroQoL and the Client Service Receipt Inventory, respectively. Analyses included
quality-adjusted life years, direct and indirect cost differences, and incremental
cost effectiveness ratios. A total of 156 FM patients were randomized (51 GACT, 52
RPT, 53 WL). GACT was related to significantly less direct costs over the 6-month
study period compared with both control arms (GACT €824.2 ± 1,062.7 vs RPT €1,730.7 ± 1,656.8
vs WL €2,462.7 ± 2,822.0). Lower direct costs for GACT compared with RPT were due
to lower costs from primary care visits and FM-related medications. The incremental
cost effectiveness ratios were dominant in the completers’ analysis and remained robust
in the sensitivity analyses. In conclusion, acceptance and commitment therapy appears
to be a cost-effective treatment compared with RPT in patients with FM.
Perspective
Decision-makers have to prioritize their budget on the treatment option that is the
most cost effective for the management of a specific patient group. From government
as well as health care perspectives, this study shows that a GACT is more cost effective
than pharmacological treatment in management of FM.
Key words
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Article info
Publication history
Published online: March 22, 2017
Accepted:
March 10,
2017
Received in revised form:
February 10,
2017
Received:
April 6,
2016
Footnotes
This project was funded in part by the Instituto de Salud Carlos III (ISCIII) through the Network for Prevention and Health Promotion in Primary Care (RD16/0007/0005 and RD16/0007/0012), by a grant for research projects on health from ISCIII (PI15/00383), and cofinanced with European Union European Regional Development Funds (ERDF). J.V.L. has a “Miguel Servet” research contract from the ISCIII (CP14/00087).
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
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© 2017 by the American Pain Society
