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Cost-Effectiveness and Cost-Utility of Internet-Delivered Exposure Therapy for Fibromyalgia: Results From a Randomized, Controlled Trial
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Functional Area Medical Psychology, Karolinska University Hospital Solna, Sweden.
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2019 (English)In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 20, no 1, p. 47-59Article in journal (Refereed) Published
Abstract [en]

Fibromyalgia (FM) is a prevalent and debilitating chronic pain disorder associated with a substantial economic burden. Although there are several studies investigating the effectiveness of psychological treatments such as cognitive-behavioral therapy for FM, studies on cost-effectiveness are scarce. The aim of the present study was to investigate the cost-effectiveness of Internet-delivered exposure therapy (iExp) for FM. We used health economic data from a recently conducted randomized, controlled trial, where 140 participants were randomized to either iExp or a waitlist control (WLC) condition. Economic data were collected at pre-treatment, post-treatment, and at the 1-year follow-up. Treatment effectiveness in relation to costs were analyzed using both a societal perspective (including all direct and indirect costs) and a health care unit perspective (including only the direct treatment costs). Bootstrapped net benefit regression analyses were also conducted, comparing the difference in costs and effects between iExp and WLC, within different willingness-to-pay scenarios. Results showed that the incremental cost-effectiveness ratio was -$15,295, indicating that iExp was highly cost-effective as each successfully treated case (treatment responder) was associated with a substantial net reduction in costs. The robustness of the results was tested in 2 different sensitivity analyses, where iExp remained cost-effective, even in a willingness-to-pay-scenario of $0. We conclude that iExp is a cost-effective treatment that generates large societal cost savings.

PERSPECTIVE: Health-economic evaluations of psychological interventions for FM are scarce. This study is a cost-effectiveness analysis of Internet-delivered exposure therapy for patients with FM. Results showed that iExp was highly cost-effective compared with no treatment, where each successfully treated case generated a substantial societal cost saving.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 20, no 1, p. 47-59
Keywords [en]
Fibromyalgia, cognitive-behavioral therapy, cost-effectiveness, health economic analysis
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Applied Psychology
Identifiers
URN: urn:nbn:se:oru:diva-71213DOI: 10.1016/j.jpain.2018.07.012ISI: 000455169700005PubMedID: 30107241Scopus ID: 2-s2.0-85058441258OAI: oai:DiVA.org:oru-71213DiVA, id: diva2:1276746
Note

Funding Agencies:

Söderström König Foundation  

Fredrik and Ingrid Thuring Foundation  

Stockholm County Council  

Karolinska Institutet 

Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-23Bibliographically approved

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