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)

JOURNAL OF PAIN

卷:18

Article

Luciano, Juan V.^1,2,3  D'Amico, Francesco^2,4  Feliu-Soler, Albert^1,2,3  McCracken, Lance M.^5,6  Aguado, Jaume⁷  Penarrubia-Maria, Maria T.^2,8  Knapp, Martin⁴  Serrano-Blanco, Antoni^1,2,10  Garcia-Campayo, Javier^2,9 

[1] Inst Recerca St Joan Deu, Esplugas de Llobregat, Spain

[2] Parc Sanitari Snt Joan Deu, Teaching Res & Innovat Unit, C Dr Antoni Pujadas 42, St Boi De Llobregat 08830, Spain

[3] Network Prevent & Hlth Promot Primary Care RedIAP, Madrid, Spain

[4] London Sch Econ & Polit Sci, Personal Social Serv Res Unit, London, England

[5] Kings Coll London, Inst Psychiat Psychol & Neurosci, London, England

[6] Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England

[7] RTI Hlth Solut, Barcelona, Spain

[8] Inst Catala Salut, Primary Hlth Ctr Bartomeu Fabres Anglada, Unitat Docent Costa Ponent, Baix Llobregat Litoral, Gava, Spain

[9] Miguel Servet Hosp, Dept Psychiat, Aragon Inst Hlth Sci, Zaragoza, Spain

[10] CIBERESP, Ctr Biomed Res Epidemiol & Publ Hlth, Madrid, Spain

关键词: Fibromyalgia;    acceptance and commitment therapy;    cost utility;    cost effectiveness;    quality-adjusted life years;   

DOI  :  10.1016/j.jpain.2017.03.001

来源: Elsevier

【 摘 要 】

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). GACTwas related to significantly less direct costs over the 6-month study period compared with both control arms (GACT (sic)824.2 +/- 1,062.7 vs RPT (sic)1,730.7 +/- 1,656.8 vs WL (sic)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. (C) 2017 by the American Pain Society

【 授权许可】

Free