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Cost-Utility of Group Acceptance and Commitment Therapy for Fibromyalgia Versus Recommended Drugs: An Economic Analysis Alongside a 6-Month Randomized Controlled Trial Conducted in Spain (EFFIGACT Study)

  • Juan V. Luciano
    Correspondence
    Address reprint requests to Juan V. Luciano, PhD, Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, C/ Dr. Antoni Pujadas 42, St. Boi de Llobregat 08830, Spain.
    Affiliations
    Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain

    Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

    Network for Prevention and Health Promotion in Primary Care (RedIAPP), Madrid, Spain
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  • Francesco D'Amico
    Affiliations
    Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

    Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom
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  • Albert Feliu-Soler
    Affiliations
    Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain

    Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

    Network for Prevention and Health Promotion in Primary Care (RedIAPP), Madrid, Spain
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  • Lance M. McCracken
    Affiliations
    Institute of Psychiatry, Psychology and Neuroscience, King's College London, and INPUT Pain Management, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
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  • Jaume Aguado
    Affiliations
    RTI Health Solutions, Barcelona, Spain
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  • María T. Peñarrubia-María
    Affiliations
    Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

    Primary Health Centre Bartomeu Fabrés Anglada, Baix Llobregat Litoral, Unitat Docent Costa de Ponent, Institut Català de la Salut, Gavà, Spain
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  • Martin Knapp
    Affiliations
    Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom
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  • Antoni Serrano-Blanco
    Affiliations
    Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain

    Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

    Centre for Biomedical Research in Epidemiology and Public Health, CIBERESP, Madrid, Spain
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  • Javier García-Campayo
    Affiliations
    Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

    Department of Psychiatry, Miguel Servet Hospital, Aragon Institute of Health Sciences (I+CS), Zaragoza, Spain
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      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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