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,