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

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.