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).
Por:
Luciano JV, Francesco D'Amico, Feliu A, McCracken LM, Aguado J, Peñarrubia-María MT, Martin Knapp, Serrano-Blanco A and García-Campayo J
Publicada:
1 jul 2017
Ahead of Print:
23 mar 2017
Resumen:
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.
Filiaciones:
Luciano JV:
Teaching, Research & 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
Open University of Catalonia, Barcelona, Spain.
Francesco D'Amico:
Network for Prevention and Health Promotion in Primary Care (RedIAPP), Madrid, Spain
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
Feliu A:
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
McCracken LM:
Institute of Psychiatry, Psychology & Neuroscience, King's College London, and INPUT Pain Management, Guy's and St Thomas' NHS Foundation Trust, London, UK
Aguado J:
RTI Health Solutions, Barcelona, Spain
Peñarrubia-María MT:
Network for Prevention and Health Promotion in Primary Care (RedIAPP), Madrid, Spain
Primary Health Centre Bartomeu Fabrés Anglada, DAP Baix Llobregat Litoral, Unitat Docent Costa de Ponent, Institut Català de la Salut, Gavà, Spain
Martin Knapp:
Personal Social Services Research Unit, London School of Economics and Political Science, London, UK
García-Campayo J:
Network for Prevention and Health Promotion in Primary Care (RedIAPP), Madrid, Spain
Department of Psychiatry, Miguel Servet Hospital, Aragon Institute of Health Sciences (I+CS), Zaragoza, Spain
Open Access
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