Arthritis Res Ther. 2008 Feb 22;10(1):R24 [Epub ahead of print]

Cost-utility of an 8-month aquatic training for women with fibromyalgia: a randomized controlled trial.

Gusi N, Tomas-Carus P.

BACKGROUND: Physical therapy in warm-water has been effective and highly recommended in persons with fibromyalgia but its efficiency remains mainly unknown. Should patients or health care managers invest in this therapy? The aim of the current study was to assess the cost-utility of adding an aquatic exercise programme to the usual care of women with fibromyalgia.

METHODS: Costs to the health care system and to society were considered in this study that included 33 participants, randomly assigned to an experimental group (n=17) or a control group (n=16). The intervention in the experimental group consisted of a one-hour, supervised, water-based exercise sessions, three times per week for 8 months. The main outcome measures were the health care costs and the number of quality-adjusted life-years (QALYs) using the time trade-off elicitation technique from the EQ-5D. Sensitivity analyses was performed for variations in the staff salary, number of women attending sessions and time spent going to the pool. The cost-effectiveness acceptability curves were created using a non-parametric bootstrap technique.

RESULTS: The mean incremental treatment costs exceeded those for usual care per patient by 517 Euros for health care costs and 1032 Euros for societal costs. The mean incremental QALY associated with the intervention was 0.131 (95% CI: 0.011 to 0.290). Each QALY gained in association with the exercise programme cost an additional 3947 Euro/QALY (95% CI: 1782 to 47,000) for a health care perspective and 7878 Euro/QALY (3559 to 93818) from a societal perspective. The curves showed a 95% probability that the addition of the water-based programme is a cost-effective strategy if the ceiling of inversion is 14200 Euro/QALY from a health care perspective and 28300 Euro/QALY from a societal perspective.

CONCLUSIONS: The addition of an aquatic exercise programme to the usual care for fibromyalgia in women, is cost-effective in terms of both health care costs and societal costs. However, the characteristics of facilities (distance from the patientsa homes and number of patients that can be accommodated per session) are major determinants to consider before investing in such a programme.

PMID: 18294367 [PubMed - as supplied by publisher]

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