Cost-effectiveness of Spa treatment for fibromyalgia: general health improvement is not for free

Zijlstra, T.R. and Braakman-Jansen, L.M.A. and Taal, E. and Rasker, J.J. and Laar van de, M.A.F.J. (2007) Cost-effectiveness of Spa treatment for fibromyalgia: general health improvement is not for free. Rheumatology, 46 (9). pp. 1454-1459. ISSN 1462-0324

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Abstract:	Objectives: To estimate the cost-effectiveness of an adjuvant treatment course of spa treatment compared with usual care only in patients with fibromyalgia syndrome (FM). - Methods: 134 patients with FM, selected from a rheumatology outpatient department and from members of the Dutch FM patient association were randomly assigned to a 2½ week spa treatment course in Tunisia or to usual care only. Results are expressed as quality-adjusted life years (QALYs) for a 6-month as well as a 12-month time horizon. Utilities were derived form the Short Form 6D (SF-6D) scores and the visual analogue scale (VAS) rating general health. Costs were reported from societal perspective. Mean incremental cost per patient and the incremental cost utility ratio (ICER) were calculated; 95% confidence intervals (CIs) were estimated using double-sided bootstrapping. - Results: The data of 128 (55 spa and 73 controls) of the 134 patients (96%) could be used for analysis. Improvement in general health was found in the spa group until 6 months of follow-up by both the SF-6D (AUC 0.32 vs 0.30, P<0.05) and the VAS (AUC 0.23 vs 0.19, P<0.01). After 1yr no significant between-group differences were found. Mean incremental cost of spa treatment was E1311 per patient (95% CI 369–2439), equalling the cost of the intervention (thalassotherapy including airfare and lodging), or E885 per patient based on a more realistic cost estimate. - Conclusions: The temporary improvement in quality of life due to an adjuvant treatment course of spa therapy for patients with FM is associated with limited incremental costs per patient.
Item Type:	Article
Copyright:	© 2007 Oxford University Press
Faculty:	Behavioural Sciences (BS)
Research Group:	Psychology, Health & Technology (PHT)
Link to this item:	http://purl.utwente.nl/publications/70960
Official URL:	http://dx.doi.org/10.1093/rheumatology/kem157
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