Economic evaluation of cognitive behavioral therapy and Internet-based guided self-help for binge-eating disorder.
Int J Eat Disord
; 51(2): 155-164, 2018 Feb.
Article
en En
| MEDLINE
| ID: mdl-29345848
ABSTRACT
OBJECTIVE:
To determine the cost-effectiveness of individual face-to-face cognitive behavioral therapy (CBT) compared to therapist guided Internet-based self-help (GSH-I) in overweight or obese adults with binge-eating disorder (BED).METHOD:
Analysis was conducted alongside the multicenter randomized controlled INTERBED trial. CBT (n = 76) consisted of up to 20 individual therapy sessions over 4 months. GSH-I (n = 71) consisted of 11 modules combining behavioral interventions, exercises including a self-monitoring food diary, psychoeducation, and 2 face-to-face coaching sessions over 4 months. Assessments at baseline, after 4 months (post-treatment), as well as 6 and 18 months after the end of treatment included health care utilization and sick leave days to calculate direct and indirect costs. Binge-free days (BFD) were calculated as effect measure based on the German version of the Eating Disorder Examination. The incremental cost-effectiveness ratio (ICER) was determined, and net benefit regressions, adjusted for comorbidities and baseline differences, were used to derive cost-effectiveness acceptability curves.RESULTS:
After controlling for baseline differences, CBT was associated with non-significantly more costs (+2,539) and BFDs (+40.1) compared with GSH-I during the 22-month observation period, resulting in an adjusted ICER of 63 per additional BFD. CBTs probability of being cost-effective increased above 80% only if societal willingness to pay (WTP) was ≥250 per BFD.DISCUSSION:
We did not find clear evidence for one of the treatments being more cost-effective. CBT tends to be more effective but also more costly. If the societal WTP for an additional BFD is low, then our results suggest that GSH-I should rather be adopted.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Terapia Cognitivo-Conductual
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Análisis Costo-Beneficio
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Trastorno por Atracón
Tipo de estudio:
Clinical_trials
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Health_economic_evaluation
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Qualitative_research
Límite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Int J Eat Disord
Año:
2018
Tipo del documento:
Article
País de afiliación:
Alemania