Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive-behavioural therapy in out-patients with anorexia nervosa.
Psychol Med
; 46(16): 3291-3301, 2016 12.
Article
en En
| MEDLINE
| ID: mdl-27609525
ABSTRACT
BACKGROUND:
Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive-behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.METHOD:
The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost-utility and assumptions underlying the base case were investigated in exploratory analyses.RESULTS:
Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾9825 and ⩾24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.CONCLUSIONS:
Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.Palabras clave
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Banco de datos:
MEDLINE
Asunto principal:
Anorexia Nerviosa
/
Terapia Cognitivo-Conductual
/
Psicoterapia Psicodinámica
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Límite:
Adult
/
Female
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Psychol Med
Año:
2016
Tipo del documento:
Article
País de afiliación:
Alemania