Background Fatigue is a prevalent symptom in inflammatory rheumatic diseases (IRDs), leading to increased healthcare costs and productivity loss. Although NICE guidelines recommend psychological support from multidisciplinary rheumatology teams for fatigue management, there is significant variation in the treatment offered, and both patients and health professionals have expressed unmet needs in accessing fatigue therapy. Despite the proven benefits of many evidence-based therapeutic programmes for fatigue, they are not widely adopted in clinical practice. Health professionals report a lack of information on costs which may be a potential reason for this gap.

Methods We developed a budget template in Microsoft Excel for rheumatology services to estimate costs tailored to their specific settings. This template is based on an earlier systematic review of 82 randomised controlled trials (RCTs) that are related to fatigue in IRDs. We screened studies from the review to identify interventions that significantly improved fatigue and had a sample size of 30 or more. Selected studies were categorised according to the type of intervention. Resource-related components of each intervention were extracted to serve as input variables for the template, including disease types covered by interventions, inclusion and exclusion criteria, intervention details (e.g., session number, duration), and staff pay band. Up-to-date staff costs were estimated using NHS pay bands and published sources of unit costs. Publications describing cost-effectiveness analyses conducted alongside the interventions described in the review were sought, and relevant cost data were also considered. The template was pre-populated with values referenced from the original RCT articles and Visual Basic functionality was used to compute summary costs. Input variables that users can use to customise in order to explore various scenarios were highlighted.

Results Of the 82 studies included in the review, 48 RCTs met the criteria for inclusion in the budget template after screening. These RCTs were categorised into five groups: Physical activity or exercise (25 RCTs), Psychoeducational interventions (14 RCTs), Multicomponent interventions (3 RCTs), Consultations (3 RCTs), and Others (3 RCTs). Each intervention is available in a dropdown menu in the template, allowing users to select and subsequently adjust parameters as needed. The summary page of the template reports the average unit cost and total cost per patient for the selected intervention.

Conclusion This template offers a method for service planners to estimate the potential costs of implementing different therapeutic programmes for fatigue in IRDs. Similar methods could be applied to other disease areas in future.