Cost-Effectiveness of a Tailored Pain Self-Management Intervention Compared to Enhanced Usual Care Among People with HIV and Chronic Pain: An Economic Evaluation.

Edwards KA, Smith KJ, Jones KF, Bair MJ, Liebschutz JM, McGill LS, Agil D, Johnson MO, Thomas T, Clay OJ, Farel CE, Napravnik S, Long D, Burkholder G, Browne L, Durr AL, Johnson B, Demonte W, Orris SM, Merlin JS. Cost-Effectiveness of a Tailored Pain Self-Management Intervention Compared to Enhanced Usual Care Among People with HIV and Chronic Pain: An Economic Evaluation. Journal of acquired immune deficiency syndromes (1999). 2025 Apr 3 DOI: 10.1097/QAI.0000000000003671.

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Abstract:

BACKGROUND: Pain self-management (PSM) interventions are low risk, effective interventions for chronic pain that have high potential for scalability. Economic evaluations are a key component to assessing scalability. We evaluated the cost-effectiveness of a tailored PSM called Skills to Manage Pain (STOMP) as compared to enhanced usual care (EUC) among people with HIV (PWH) and chronic pain. SETTING: and Methods: Data are from a randomized controlled trial of STOMP (N = 278). From a healthcare perspective, a Markov decision analysis model over a 12-month time horizon was used. Participants were recruited from two academic medical centers within the Center for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. STOMP involves six individual sessions and six peer-led group sessions. The EUC control group received the STOMP treatment manual. The primary outcome was the incremental cost-effectiveness ratio, defined as US dollars per quality-adjusted life-year (QALY) gained derived from trial-based Medical Outcomes Study Short-Form 12 (SF-12) data. Sensitivity analyses examined the effects of parameters varied individually and collectively on model results. RESULTS: Participants were middle-aged (M = 53.5, SD = 10), male (53%), and Black/African American (81%). Model calculation of effectiveness over the 12-month time horizon resulted in 0.570 QALYs for EUC and 0.603 QALYs for the STOMP intervention, or 0.033 QALYs gained by STOMP compared to EUC. In probabilistic sensitivity analyses that varied all parameters simultaneously, the STOMP intervention was favored in 98.0% of 10,000 model iterations at a $100,000/QALY threshold. CONCLUSIONS: STOMP is a cost-effective and scalable PSM intervention for PWH and chronic pain.