Impact of balneotherapy on drug consumption: a systematic review and an economic evaluation of drug deprescribing

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: NSAIDs savings: €0.05-1.03 million (mean €504,900); Analgesics savings: €0.73-2.31 million (mean €1,547,400)

• Primary Outcome: Economic savings from reduced drug consumption following balneotherapy

• Nnt Or Sensitivity: Cost savings per patient: approximately €1.14-2.33 for NSAIDs, €1.65-5.23 for analgesics based on 441,776 treated patients

• Confidence Interval: Not reported

Clinical Application

Limited by availability of balneotherapy facilities and uncertain reimbursement outside France Limited applicability - balneotherapy not widely available through PBS; would require private payment or specific spa facility access. RACGP guidelines emphasise non-pharmacological approaches for chronic pain management Patients with rheumatological conditions considering non-pharmacological treatment options

Abstract

Some previous studies have suggested that balneotherapy could be associated with a decrease in drug consumption. No study has investigated pharmacoeconomic consequences in terms of monetary savings. The present study was performed to evaluate potential savings (according to societal perspective) associated with decreased drug consumption resulting from spa treatments using randomized clinical trials (RCT) identified after a systematic review. Among 48 RCT, 8 trials investigating rheumatological diseases (low back or shoulder pain, osteoarthritis, ankylosing spondylitis, fibromyalgia), were included in the economic evaluation of direct costs (€) using 2024 data of drug reimbursements according to French health insurance data. Savings calculated related to non-steroidal anti-inflammatory drugs (NSAIDs') decrease were between €0.05 million and €1.03 million at 6 months (mean value: €504.900) for the 441,776 patients who underwent rheumatology-oriented spa treatment in France in 2024 versus controls. For analgesics, values ranged from €0.73 million to around €2.31 million (mean value: €1,547.400). Despite several limitations that could not be overlooked (heterogeneity of studied populations, interventions, duration, outcome measures), the study showsfor the first timethat decreased drug consumption resulting from balneotherapy is associated with important savings regarding NSAIDs and, to a greater extent, analgesics. Balneotherapy is a unique opportunity for deprescribing, enabling both significant monetary savings for national health insurance, complementary health insurances and patients, while preventing adverse drug reactions or decreasing physiotherapy sessions or hospitalizations.

References

1. 1.Montastruc, J. L., & Bouvier, C. E. (2026). Impact of balneotherapy on drug consumption: a systematic review and an economic evaluation of drug deprescribing. International Journal of Biometeorology. https://doi.org/10.1002/art.10658