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) - 06/10/17
, Francesco D'Amico †, §, Albert Feliu-Soler ∗, †, ‡, Lance M. McCracken ¶, Jaume Aguado ||, María T. Peñarrubia-María †, ∗∗, Martin Knapp §, Antoni Serrano-Blanco ∗, †, ‡‡, Javier García-Campayo †, ††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.
Le texte complet de cet article est disponible en PDF.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. |
Key words : Fibromyalgia, acceptance and commitment therapy, cost utility, cost effectiveness, quality-adjusted life years
Plan
| 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). |
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| The authors have no conflicts of interest to declare. |
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| Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com. |
Vol 18 - N° 7
P. 868-880 - juillet 2017 Retour au numéro
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