Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study)

Juan V. Luciano; Francesco D’Amico; Albert Feliu-Soler; Lance M. McCracken; Jaume Aguado; María T. Peñarrubia-María; Martin Knapp; Antoni Serrano-Blanco; Javier García-Campayo

doi:10.1016/j.jpain.2017.03.001

Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study)

Juan V. Luciano, Francesco D’Amico, Albert Feliu-Soler, Lance M. McCracken, Jaume Aguado, María T. Peñarrubia-María, Martin Knapp, Antoni Serrano-Blanco, Javier García-Campayo

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Abstract

The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively. Analyses included Quality-Adjusted Life Years (QALYs), direct and indirect cost differences, and incremental cost-effectiveness ratios (ICERs). 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 to 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 in comparison to RPT were due to lower costs from primary care visits and FM-related medications. The ICERs were dominant in the completers’ analysis and remained robust in the sensitivity analyses. In conclusion, ACT appears to be a cost-effective treatment in comparison to RPT in patients with FM. Perspective Decision-makers have to prioritise their budget on the treatment option that is the most cost-effective for the management of a specific patient group. From both government and healthcare perspective, this study shows that a group-based form of Acceptance and Commitment Therapy is more cost-effective than pharmacological treatment in management of fibromyalgia.

Original language	English
Journal	JOURNAL OF PAIN
Early online date	23 Mar 2017
DOIs	https://doi.org/10.1016/j.jpain.2017.03.001
Publication status	E-pub ahead of print - 23 Mar 2017

Keywords

Fibromyalgia
Acceptance and Commitment Therapy
Cost-utility
Cost-effectiveness
Quality-adjusted life years

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10.1016/j.jpain.2017.03.001

Cost-utility of Group_LUCIANO_Accepted10March2017_GREEN AAMAccepted author manuscript, 321 KBLicence: CC BY-NC-ND

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Luciano, J. V., D’Amico, F., Feliu-Soler, A., McCracken, L. M., Aguado, J., Peñarrubia-María, M. T., Knapp, M., Serrano-Blanco, A., & García-Campayo, J. (2017). Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study). JOURNAL OF PAIN. Advance online publication. https://doi.org/10.1016/j.jpain.2017.03.001

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abstract = "The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively. Analyses included Quality-Adjusted Life Years (QALYs), direct and indirect cost differences, and incremental cost-effectiveness ratios (ICERs). 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 to 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 in comparison to RPT were due to lower costs from primary care visits and FM-related medications. The ICERs were dominant in the completers{\textquoteright} analysis and remained robust in the sensitivity analyses. In conclusion, ACT appears to be a cost-effective treatment in comparison to RPT in patients with FM. Perspective Decision-makers have to prioritise their budget on the treatment option that is the most cost-effective for the management of a specific patient group. From both government and healthcare perspective, this study shows that a group-based form of Acceptance and Commitment Therapy is more cost-effective than pharmacological treatment in management of fibromyalgia.",

keywords = "Fibromyalgia, Acceptance and Commitment Therapy, Cost-utility, Cost-effectiveness, Quality-adjusted life years",

author = "Luciano, {Juan V.} and Francesco D{\textquoteright}Amico and Albert Feliu-Soler and McCracken, {Lance M.} and Jaume Aguado and Pe{\~n}arrubia-Mar{\'i}a, {Mar{\'i}a T.} and Martin Knapp and Antoni Serrano-Blanco and Javier Garc{\'i}a-Campayo",

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Luciano, JV, D’Amico, F, Feliu-Soler, A, McCracken, LM, Aguado, J, Peñarrubia-María, MT, Knapp, M, Serrano-Blanco, A & García-Campayo, J 2017, 'Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study)', JOURNAL OF PAIN. https://doi.org/10.1016/j.jpain.2017.03.001

Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study). / Luciano, Juan V.; D’Amico, Francesco; Feliu-Soler, Albert et al.
In: JOURNAL OF PAIN, 23.03.2017.

Research output: Contribution to journal › Article › peer-review

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T1 - Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study)

AU - Luciano, Juan V.

AU - D’Amico, Francesco

AU - Feliu-Soler, Albert

AU - McCracken, Lance M.

AU - Aguado, Jaume

AU - Peñarrubia-María, María T.

AU - Knapp, Martin

AU - Serrano-Blanco, Antoni

AU - García-Campayo, Javier

PY - 2017/3/23

Y1 - 2017/3/23

N2 - The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively. Analyses included Quality-Adjusted Life Years (QALYs), direct and indirect cost differences, and incremental cost-effectiveness ratios (ICERs). 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 to 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 in comparison to RPT were due to lower costs from primary care visits and FM-related medications. The ICERs were dominant in the completers’ analysis and remained robust in the sensitivity analyses. In conclusion, ACT appears to be a cost-effective treatment in comparison to RPT in patients with FM. Perspective Decision-makers have to prioritise their budget on the treatment option that is the most cost-effective for the management of a specific patient group. From both government and healthcare perspective, this study shows that a group-based form of Acceptance and Commitment Therapy is more cost-effective than pharmacological treatment in management of fibromyalgia.

AB - The aim of this study was to analyse the cost-utility of a group-based form of Acceptance and Commitment Therapy (GACT) in patients with fibromyalgia (FM) compared to patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, an RCT that focused on clinical outcomes. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively. Analyses included Quality-Adjusted Life Years (QALYs), direct and indirect cost differences, and incremental cost-effectiveness ratios (ICERs). 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 to 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 in comparison to RPT were due to lower costs from primary care visits and FM-related medications. The ICERs were dominant in the completers’ analysis and remained robust in the sensitivity analyses. In conclusion, ACT appears to be a cost-effective treatment in comparison to RPT in patients with FM. Perspective Decision-makers have to prioritise their budget on the treatment option that is the most cost-effective for the management of a specific patient group. From both government and healthcare perspective, this study shows that a group-based form of Acceptance and Commitment Therapy is more cost-effective than pharmacological treatment in management of fibromyalgia.

KW - Fibromyalgia

KW - Acceptance and Commitment Therapy

KW - Cost-utility

KW - Cost-effectiveness

KW - Quality-adjusted life years

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DO - 10.1016/j.jpain.2017.03.001

M3 - Article

SN - 1526-5900

JO - JOURNAL OF PAIN

JF - JOURNAL OF PAIN

ER -

Luciano JV, D’Amico F, Feliu-Soler A, McCracken LM, Aguado J, Peñarrubia-María MT et al. Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study). JOURNAL OF PAIN. 2017 Mar 23. Epub 2017 Mar 23. doi: 10.1016/j.jpain.2017.03.001

Cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: An economic analysis alongside a 6-month randomised controlled trial conducted in Spain (EFFIGACT study)

Abstract

Keywords

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