Cognitive-educational treatment of fibromyalgia (FM): a randomized clinical trial. II. Economic evaluation

OBJECTIVE: In this 3 year randomized clinical trial the cost

effectiveness of a 6 week educational/cognitive intervention

(ECO) is compared with an educational discussion intervention

(EDI) and a waiting list condition (WLC).

METHODS: A total of

131 patients with fibromyalgia were randomly allocated to the

ECO, EDI, or WLC intervention. The ECO and EDI groups were

followed for 12 months, whereas the WLC group was followed

for 6 weeks. Direct health care and nonhealth care costs, and

the indirect costs associated with lost production due to

illness, were calculated. The effects were measured in terms

of utilities, using rating scale and standard gamble methods.

RESULTS: Treatment costs were estimated to be US $980 per

patient for both ECO and EDI. The total direct health care

costs of ECO treatment were US $1623 higher than those for

EDI. This difference was significant. Indirect costs for the

2 groups were not significantly different. At 6 weeks there

was a significant difference in rating scale utilities

between the 3 groups, caused by a significantly greater

improvement in the EDI group compared to the WLC group.

However, no significant differences in either rating scale or

standard gamble utilities were found between the ECO and EDI

groups immediately after treatment, or at the 6 or 12 month


CONCLUSION: The economic evaluation showed that

the addition of a cognitive component to the educational

intervention led to significantly higher health care costs and

no additional improvement in quality of life compared to the

educational intervention alone. This conclusion is robust

through a range of plausible values used in a sensitivity


MCM: Addition of a cognitive component to educational

intervention led to no additional improvement in quality of

life compared to educational intervention alone.

Goossens ME, Rutten-van Molken MP, Leidl RM,Bos SG,Vlaeyen JW,

Teeken-Gruben NJ

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