Vos-Vromans, Desirée, Evers, Silvia, Huijnen, Ivan et al. · PloS one · 2017 · DOI
This study compared the cost and effectiveness of two treatments for ME/CFS: multidisciplinary rehabilitation treatment (MRT), which involves physical therapy, psychology, and medical care working together, versus cognitive behavioural therapy (CBT), which focuses on changing thinking patterns and behaviors. Over one year, MRT reduced fatigue more effectively than CBT, but it cost significantly more money. Whether MRT is worth the extra cost depends on which outcome you prioritize—if fatigue reduction is most important, MRT appears cost-effective; if overall quality of life is most important, CBT may be better value.
Economic evidence is critical for healthcare systems deciding which treatments to fund for ME/CFS patients. This study directly compares two commonly-offered treatments not just on effectiveness but on whether that effectiveness justifies the cost, providing policymakers and patients with data to make informed resource allocation decisions.
This study does not prove which treatment is objectively 'better'—the conclusion depends on whether you prioritize fatigue reduction versus broader quality-of-life and economic burden. The study also cannot determine whether observed treatment effects are sustained beyond 52 weeks or whether results generalize to ME/CFS diagnosed by other case definitions (e.g., ME-ICC).
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Vos-Vromans, Desirée, Evers, Silvia, Huijnen, Ivan, Köke, Albère, Hitters, Minou, Rijnders, Nieke, et al. (2017). Economic evaluation of multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: A randomized controlled trial.. PloS one. https://doi.org/10.1371/journal.pone.0177260
BibTeX
@article{mecfsatlas-vos-vromans-2017-economic-evaluation,
author = {Vos-Vromans, Desirée and Evers, Silvia and Huijnen, Ivan and Köke, Albère and Hitters, Minou and Rijnders, Nieke and Pont, Menno and Knottnerus, André and Smeets, Rob},
title = {Economic evaluation of multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: A randomized controlled trial.},
journal = {PloS one},
year = {2017},
doi = {10.1371/journal.pone.0177260},
note = {PubMed: 28574985},
url = {https://www.mecfsatlas.com/evidence/vos-vromans-2017-economic-evaluation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/vos-vromans-2017-economic-evaluation
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