Non-pharmacological interventions are recommended for the treatment of fibromyalgia, but there is a lack of knowledge about the cost-effectiveness of these interventions. The aim of this study was to systematically review economic evaluations of educational, physical and psychological interventions for the treatment of fibromyalgia. Search were performed in PUBMED, EMBASE, CINAHL, Cochrane Library, PEDro, PsycINFO, EconLit, NHS EED and HTA. Economic evaluations of educational, physical and psychological interventions for adult patients with fibromyalgia were included. Primary outcomes were healthcare and societal costs, and quality-adjusted life-years (QALYs), and secondary outcomes were any disease-specific clinical outcome. Costs and effects were pooled in a meta-analysis, when possible. Eleven studies were included, of which seven compared a psychological intervention with another intervention or usual care/control. Over a 6-month time horizon, healthcare and societal costs of the psychological intervention were significantly lower than usual care (mean difference: $-2,087, 95%CI: -3,061 to -1,112; mean difference: $-2,411, 95%CI: -3,582 to -1,240, respectively), and healthcare costs were significantly lower for the psychological intervention compared to a pharmacological intervention (mean difference: $-1,443, 95%CI: -2,165 to -721). Over a 12-month time horizon, healthcare costs for the psychological intervention were significantly lower than for usual care (mean difference: $-538, 95%CI: -917 to -158). Incremental cost-effectiveness ratios for QALYs and impact of fibromyalgia showed that the psychological intervention was cost-effective compared with other interventions and control conditions. There is a need of more economic evaluations conducted alongside randomized controlled trials with interventions recommended for the treatment of fibromyalgia, such as physical exercise.
CRD42019119972.

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