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)
Open accessAbstract
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.Perspective 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.
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Our results coincide with those of other studies that showed a relationship between an optimistic disposition towards activities (acceptance) and a greater resistance to the psychological or biological effects of emotional distress.
“Our results coincide with those of other studies that showed a relationship between an optimistic disposition towards activities (acceptance) and a greater resistance to the psychological or biological effects of emotional distress (43, 44).”
From Identifying mindfulness and acceptance as mediators between negative affect, functional disability and emotional distress in patients with fibromyalgia (2021) · cites this paper as [44]
The trial summary (Accepted Manuscript; page not provided) reports greater pain acceptance and less anxiety and depression after group ACT than after recommended pharmacotherapy in patients with fibromyalgia. It does not establish that an optimistic disposition toward activities predicts resistance to emotional distress, and it does not report resistance to biological effects. (LLM, conf=0.77)
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- Authors
- 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.
- Affiliations
- Red de Investigación en Actividades Preventivas y Promoción de la Salud (ES)
- King's College London (GB)
- London School of Economics and Political Science (GB)
- Corresponding author
- Luciano, Juan V.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 18
- Issue
- 7
- Pages
- 868-880
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W2603660327
- Cited by
- 42
- References
- 36
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 6 · 2017: 4
- FWCI
- 11.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (acceptedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Funders
- European Commission
- Instituto de Salud Carlos III (RD16/0007, RD16/0007/0012, RD16/0007/0005, PI15/00383, CP14/00087)
- European Regional Development Fund (RD16/0007, RD16/0007/0012)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- fibromyalgia, acceptance and commitment therapy, group therapy, cost-effectiveness, pharmacotherapy, quality-adjusted life years, health-related quality of life, health care costs, primary care visits, waiting lists, incremental cost-effectiveness ratio
- MeSH terms
- Duloxetine Hydrochloride, Pregabalin, Adult, Analgesics, Cost-Benefit Analysis, Female, Fibromyalgia, Humans, Male, Middle Aged, Psychotherapy, Group, Spain, Outcome Assessment, Health Care, Acceptance and Commitment Therapy
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