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The following is a summary of “Cost-effectiveness and cost-utility of exposure-based vs. traditional cognitive behavior therapy for fibromyalgia: results from a randomized controlled trial,” published in the March 2025 issue of Journal of Pain by Hedman-Lagerlöf et al. 

Fibromyalgia (FM) imposes high economic costs, highlighting the need for evaluating cost-effective treatment options.  

Researchers conducted a retrospective study to assess the cost-effectiveness of online exposure therapy-Cognitive behavior therapy (EXP-CBT) compared to online traditional CBT (T-CBT) for FM.  

They examined health economic data from a randomized controlled trial (RCT) involving 274 participants with FM assigned to either online EXP-CBT or online T-CBT. The analysis covered a 15-month period, assessing treatment effectiveness and costs from both a societal perspective (direct and indirect costs) and a health care perspective (direct medical costs only). Bootstrapped net benefit regression analyses were performed to compare cost and effect differences between EXP-CBT and T-CBT across various willingness-to-pay scenarios.  

The results showed that the incremental cost-effectiveness ratio was -$16,884 (-1477/0.09) from the societal perspective, supporting the cost-effectiveness of online EXP-CBT. Each additional treatment responder in EXP-CBT, compared to online T-CBT, incurred lower costs, with a 69% probability of cost-effectiveness at a willingness-to-pay threshold of $0. The cost-utility analysis yielded -$28,763 (-1477/0.05), also with a 69% probability of EXP-CBT being cost-effective at a willingness-to-pay threshold of $0. No significant differences were observed in total costs or treatment effectiveness between EXP-CBT and T-CBT.  

Investigators concluded that while online EXP potentially offered a more cost-effective option than online T-CBT, the study found no significant differences in either cost or effectiveness between the 2 treatments. 

Source: jpain.org/article/S1526-5900(25)00602-9/fulltext