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).
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.



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.
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. Electronic address: jvluciano@pssjd.org.
Juan V
JV
Luciano
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.
Francesco
F
D'Amico
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.
Albert
A
Feliu-Soler
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.
Lance M
LM
McCracken
RTI Health Solutions, Barcelona, Spain.
Jaume
J
Aguado
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.
María T
MT
Peñarrubia-María
Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom.
Martin
M
Knapp
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.
Antoni
A
Serrano-Blanco
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.
Javier
J
García-Campayo
D064869:Acceptance and Commitment Therapy / Q000191:economics; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000191:economics* / Q000494:pharmacology*; D003362:Cost-Benefit Analysis; D000068736:Duloxetine Hydrochloride / Q000191:economics / Q000494:pharmacology; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy / Q000191:economics* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics; D000069583:Pregabalin / Q000191:economics / Q000494:pharmacology; D011615:Psychotherapy, Group / Q000191:economics; D013030:Spain
D000700:Analgesics; D000069583:Pregabalin; D000068736:Duloxetine Hydrochloride
Fibromyalgia; acceptance and commitment therapy; cost effectiveness; cost utility; quality-adjusted life years