Long-term economic evaluation of cognitive-behavioural group treatment versus enhanced usual care for functional somatic syndromes
Abstract
Objective Patients with functional somatic syndromes (FSS) such as fibromyalgia and chronic fatigue syndrome have a poor outcome and can incur high healthcare and societal costs. We aimed to compare the medium-term (16months) cost-effectiveness and the long-term (40months) economic outcomes of a bespoke cognitive-behavioural group treatment (STreSS) with that of enhanced usual care (EUC).Methods We obtained complete data on healthcare and indirect costs (i.e. labour marked-related and health-related benefits) from public registries for 120 participants from a randomised controlled trial. Costs were calculated as per capita public expenses in 2010 €. QALYs gained were estimated from the SF-6D. We conducted a medium-term cost-effectiveness analysis and a long-term cost-minimization analysis from both a healthcare (i.e. direct cost) and a societal (i.e. total cost) perspective.Results In the medium term, the probability that STreSS was cost-effective at thresholds of 25,000 to 35,000 € per QALY was 93-95% from a healthcare perspective, but only 50-55% from a societal perspective. In the long term, however, STreSS was associated with increasing savings in indirect costs, mainly due to a greater number of patients self-supporting. When combined with stable long-term reductions in healthcare expenditures, there were total cost savings of 7184 € (95% CI 2271 to 12,096, p=0.004) during the third year after treatment.Conclusion STreSS treatment costs an average of 1545 €. This cost was more than offset by subsequent savings in direct and indirect costs. Implementation could both improve patient outcomes and reduce costs.
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Functional somatic disorder multi-organ type is associated with substantial socioeconomic costs, involving expensive diagnostic examinations, sick leave, and long-term disability.
“The condition causes suffering and reduced quality of life and is associated with substantial socioeconomic costs, involving expensive diagnostic examinations, sick leave, and long-term disability [2,13,14].”
From Internet-delivered treatment for patients suffering from severe functional somatic disorders: Protocol for a randomized controlled trial (2023) · cites this paper as [14]
Functional somatic disorder multi-organ type causes suffering and reduced quality of life.
“The condition causes suffering and reduced quality of life and is associated with substantial socioeconomic costs, involving expensive diagnostic examinations, sick leave, and long-term disability [2,13,14].”
From Internet-delivered treatment for patients suffering from severe functional somatic disorders: Protocol for a randomized controlled trial (2023) · cites this paper as [14]
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“2 reduced quality of life and is associated with substantial socioeconomic costs, involving expensive diagnostic examinations, sick leave, and long-term disability [2,13,14].”
BackgroundFuncData - A national database for functional somatic disorders in Denmark
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A nationwide healthcare program for functional somatic disorders (FSD) in Denmark
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- Authors
- Schröder, A., Ørnbøl, E., Jensen, J. S., Sharpe, M., & Fink, P.
- Affiliations
- Aarhus University Hospital (DK)
- University of Oxford (GB)
- Corresponding author
- Schröder, Andreas
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 94
- Pages
- 73-81
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2570521248
- Cited by
- 25
- References
- 50
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 6 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 5
- FWCI
- 2.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Aarhus University Hospital Research Initiative
- A.P. Møller Foundation for the Advancement of Medical Science
- Medical Association for the County of Aarhus
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- functional somatic syndromes, fibromyalgia, chronic fatigue syndrome, stress, enhanced usual care, cost-effectiveness, cost-minimization analysis, indirect costs, health care costs, quality-adjusted life years, social costs, long-term cost savings
- MeSH terms
- Adult, Cost-Benefit Analysis, Female, Fibromyalgia, Humans, Male, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Quality-Adjusted Life Years
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