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Article Abstract
Objective: To compare the cost-utility of transdiagnostic cognitive behavioural therapy (TDT-CBT) plus standardised medical care (SMC) to SMC alone to support people with persistent physical symptoms in contact with specialist services.
Methods: This study compared the cost-utility of TDT-CBT. A two-arm randomised controlled trial was conducted in secondary care settings. Participants received either TDT-CBT + SMC or SMC alone. Measures were taken at baseline and at 9-, 20-, 40-, and 52-week follow-up. Service use was measured, and costs calculated. Costs were combined with quality-adjusted life years (QALYs) based on the EQ-5D-5L using incremental cost-utility ratios with uncertainty addressed using cost-effectiveness planes and acceptability curves.
Results: The costs during the follow-up period were £3473 for TDT-CBT + SMC and £3104 for SMC alone. The incremental cost for TDT-CBT + SMC adjusting for baseline was £482 (95 % CI, -£399 to £1233). QALYs over the follow-up were 0.578 for TDT-CBT + SMC and 0.542 for SMC alone. The incremental QALY was 0.038 (95 % CI, -0.005 to 0.080). The incremental cost per QALY was £12,684 for TDT-CBT + SMC. There was a 68.3 % likelihood that TDT-CBT + SMC was the most cost-effective option at a threshold of £20,000 per QALY.
Conclusion: Adding TDT-CTB to SMC results in slightly increased costs and slightly better outcomes in terms of QALYs. This represents a cost-effective option based on the conventional QALY threshold value.
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| http://dx.doi.org/10.1016/j.jpsychores.2024.111960 | DOI Listing |
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