Cost-utility of a multicomponent intervention for fibromyalgia versus usual care: a pragmatic randomised controlled trial.
Victoria Mailen Arfuch, Carina Aguilar Martín, Anna Berenguera and 9 others
PMID 38111994WHAT IT FOUND
A multicomponent programme improved quality-adjusted life years significantly compared with usual care, with costs rising slightly but staying well below the standard willingness-to-pay threshold.
Adherence was high, and excluding those who attended fewer than 8 sessions showed cost savings.
Key findings
01The intervention group showed a significant improvement in quality-adjusted life years (0.12 gain) compared with the control group.
02Total costs decreased for both groups post-intervention, with no significant difference between them.
03Sensitivity analysis excluding participants with less than 66% session attendance resulted in a dominant scenario for the intervention, meaning it was both cheaper and more effective.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was conducted during the COVID-19 pandemic, which may have affected costs and health outcomes for both groups. Only complete cases were analysed; 25% of the initial sample was excluded due to missing data. Direct medical costs could not be specifically attributed to fibromyalgia diagnosis and treatment, potentially overestimating real costs. Productivity losses were estimated using a human capital approach, which may overestimate costs by not accounting for work replacement. Results are specific to the regional population and healthcare system in Spain.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the cost-saving result in the sensitivity analysis as the primary finding. The main analysis showed a slight cost increase (though well below the threshold), and the cost-saving scenario only appeared when excluding participants with low session attendance.