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Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review

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  • Margreet S H Wortman
  • Joran Lokkerbol
  • Johannes C van der Wouden
  • Bart Visser
  • Henriëtte E van der Horst
  • Tim C olde Hartman

Abstract

Background: In primary and secondary care medically unexplained symptoms (MUS) or functional somatic syndromes (FSS) constitute a major burden for patients and society with high healthcare costs and societal costs. Objectives were to provide an overview of the evidence regarding the cost-effectiveness of interventions for MUS or FSS, and to assess the quality of these studies. Methods: We searched the databases PubMed, PsycINFO, the National Health Service Economic Evaluation Database (NHS-EED) and the CEA registry to conduct a systematic review. Articles with full economic evaluations on interventions focusing on adult patients with undifferentiated MUS or fibromyalgia (FM), irritable bowel syndrome (IBS) and chronic fatigue syndrome (CFS), with no restrictions on comparators, published until 15 June 2018, were included. We excluded preventive interventions. Two reviewers independently extracted study characteristics and cost-effectiveness data and used the Consensus on Health Economic Criteria Checklist to appraise the methodological quality. Results: A total of 39 studies out of 1,613 articles met the inclusion criteria. Twenty-two studies reported costs per quality-adjusted life year (QALY) gained and cost-utility analyses (CUAs). In 13 CUAs the intervention conditions dominated the control conditions or had an incremental cost-effectiveness ratio below the willingness-to-pay threshold of € 50,000 per QALY, meaning that the interventions were (on average) cost-effective in comparison with the control condition. Group interventions focusing on MUS (n = 3) or FM (n = 4) might be more cost-effective than individual interventions. The included studies were heterogeneous with regard to the included patients, interventions, study design, and outcomes. Conclusion: This review provides an overview of 39 included studies of interventions for patients with MUS and FSS and the methodological quality of these studies. Considering the limited comparability due to the heterogeneity of the studies, group interventions might be more cost-effective than individual interventions. Registration: Study methods were documented in an international prospective register of systematic reviews (PROSPERO) protocol, registration number: CRD42017060424.

Suggested Citation

  • Margreet S H Wortman & Joran Lokkerbol & Johannes C van der Wouden & Bart Visser & Henriëtte E van der Horst & Tim C olde Hartman, 2018. "Cost-effectiveness of interventions for medically unexplained symptoms: A systematic review," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-23, October.
    • Handle: RePEc:plo:pone00:0205278
    DOI: 10.1371/journal.pone.0205278
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    1. McCrone, Paul R. & Sharpe, Michael & Chalder, Trudie & Knapp, Martin & Johnson, Anthony L. & Goldsmith, Kimberley A. & White, Peter D., 2012. "Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis," LSE Research Online Documents on Economics 45274, London School of Economics and Political Science, LSE Library.
    2. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement," PharmacoEconomics, Springer, vol. 31(5), pages 361-367, May.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    4. Nadja Chernyak & Heribert Sattel & Marsel Scheer & Christina Baechle & Johannes Kruse & Peter Henningsen & Andrea Icks, 2014. "Economic Evaluation of Brief Psychodynamic Interpersonal Therapy in Patients with Multisomatoform Disorder," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-4, January.
    5. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    6. Desirée Vos-Vromans & Silvia Evers & Ivan Huijnen & Albère Köke & Minou Hitters & Nieke Rijnders & Menno Pont & André Knottnerus & Rob Smeets, 2017. "Economic evaluation of multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: A randomized controlled trial," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-21, June.
    7. Mark Fisher & Andrew Walker & Meritxell Falqués & Miguel Moya & Mark Rance & Douglas Taylor & Leandro Lindner, 2016. "Cost-effectiveness of linaclotide compared to antidepressants in the treatment of irritable bowel syndrome with constipation in Scotland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1091-1100, December.
    8. Paul McCrone & Michael Sharpe & Trudie Chalder & Martin Knapp & Anthony L Johnson & Kimberley A Goldsmith & Peter D White, 2012. "Adaptive Pacing, Cognitive Behaviour Therapy, Graded Exercise, and Specialist Medical Care for Chronic Fatigue Syndrome: A Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-9, August.
    9. Luciano, Juan V. & D’Amico, Francesco & Cerdà-Lafont, Marta & Peñarrubia-María, María T. & Knapp, Martin & Cuesta-Vargas, Antonio I. & Serrano-Blanco, Antoni & García-Campayo, Javier, 2014. "Cost-utility of cognitive behavioral therapy versus U.S. Food and Drug Administration recommended drugs and usual care in the treatment of patients with fibromyalgia: an economic evaluation alongside ," LSE Research Online Documents on Economics 60348, London School of Economics and Political Science, LSE Library.
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