2026-05-31T03:04:59Zhttps://riuma.uma.es/rest/oai/request

oai:riuma.uma.es:10630/378662026-02-03T11:04:29Zcom_10630_2254col_10630_37953

Cost-utility of cognitive behavioral therapy versus U.S. Food and Drug Administration recommended drugs and usual care in the treatment of patients with fibromyalgia: an economic evaluation alongside a 6-month randomized controlled trial Luciano, Juan V D'Amico, Francesco Cerdà-Lafont, Marta Peñarrubia-María, María T Knapp, Martin Cuesta-Vargas, Antonio Serrano-Blanco, Antoni Garcia Campayo, Javier Enfermos de fibromialgia - Asistencia sanitaria - Aspectos económicos Introduction: Cognitive behavioral therapy (CBT) and U.S. Food and Drug Administration (FDA)-recommended pharmacologic treatments (RPTs; pregabalin, duloxetine, and milnacipran) are effective treatment options for fibromyalgia (FM) syndrome and are currently recommended by clinical guidelines. Methods: The economic evaluation was conducted alongside a 6-month, multicenter, randomized, blinded, parallel group, controlled trial. In total, 168 FM patients from 41 general practices in Zaragoza (Spain) were randomized to CBT (n = 57), RPT (n = 56), or TAU (n = 55). The main outcome measures were Quality-Adjusted Life Years (QALYs, assessed by using the EuroQoL-5D questionnaire) and improvements in health-related quality of life (HRQoL, assessed by using EuroQoL-5D visual analogue scale, EQ-VAS). The costs of healthcare use were estimated from patient self-reports (Client Service Receipt Inventory). Results: On average, the total costs per patient in the CBT group (1,847 €) were significantly lower than those in patients receiving RPT (3,664 €) or TAU (3,124 €). Patients receiving CBT reported a higher quality of life (QALYs and EQ-VAS scores); the differences between groups were significant only for EQ-VAS. From a complete case-analysis approach (base case), the point estimates of the cost-effectiveness ratios resulted in dominance for the CBT group in all of the comparisons performed, by using both QALYs and EQ-VAS as outcomes. These findings were confirmed by bootstrap analyses, net-benefit curves, and CEACs. Two additional sensitivity analyses (intention-to-treat analysis and per-protocol analysis) indicated that the results were robust. Conclusions: Because of lower costs, CBT is the most cost-effective treatment for adult FM patients. Implementation in routine medical care would require policymakers to develop more-widespread public access to trained and experienced therapists in group-based forms of CBT. 2025-02-14T09:03:31Z 2025-02-14T09:03:31Z 2025-02-14T09:03:31Z 2014-10-01 journal article Luciano JV, D'Amico F, Cerdà-Lafont M, Peñarrubia-María MT, Knapp M, Cuesta-Vargas AI, Serrano-Blanco A, García-Campayo J. Cost-utility of cognitive behavioral therapy versus U.S. Food and Drug Administration recommended drugs and usual care in the treatment of patients with fibromyalgia: an economic evaluation alongside a 6-month randomized controlled trial. Arthritis Res Ther. 2014 Oct 1;16(5):451. doi: 10.1186/s13075-014-0451-y. PMID: 25270426; PMCID: PMC4203881. https://hdl.handle.net/10630/37866 10.1186/s13075-014-0451-y eng open access BMC Springer Nature