Cognitive behaviour therapy for improving social recovery in psychosis: Cost-effectiveness analysis

被引:21
作者
Barton, Garry R. [1 ]
Hodgekins, Jo [1 ]
Mugford, Miranda [1 ]
Jones, Peter B. [2 ,3 ]
Croudace, Tim [2 ]
Fowler, David [1 ]
机构
[1] Univ E Anglia, Sch Med Hlth Policy & Practice, Norwich NR4 7TJ, Norfolk, England
[2] Univ Cambridge, Dept Psychiat, Cambridge, England
[3] Cambridgeshire & Peterborough Mental Hlth Partner, CAMEO, Peterborough, Cambs, England
基金
英国医学研究理事会;
关键词
Cost-effectiveness; Psychosis; CBT; PRIMARY-CARE; MISSING DATA; EUROQOL; TRIAL; INFORMATION; DISORDERS; PROGRAMS; PEOPLE;
D O I
10.1016/j.schres.2009.03.041
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
A randomised trial was conducted in order to estimate the clinical and cost-effectiveness of social recovery orientated cognitive behavioural therapy (SRCBT) for people diagnosed with psychosis, compared to case management alone (CMA). The mean incremental health and social care cost, and the mean incremental quality adjusted life year (QALY) gain, of SRCBT was calculated over the 9 month intervention period. The cost-effectiveness of SCRBT was in turn estimated, and considered in relation to the cost-effectiveness threshold of (sic)20 000 per QALY. The level of uncertainty associated with that decision was estimated by calculating the cost-effectiveness acceptability curve for SRCBT. N = 35 received SRCBT and N = 42 received CMA. The mean incremental cost was estimated to be (sic)668, and the mean incremental QALY gain 0.035. SRCBT was estimated to be cost-effective as it had a cost per QALY of (sic)18844, which was more favourable than the assumed cost-effectiveness threshold of (sic)20 000 per QALY. At that threshold the probability of being cost-effective was however estimated to be 54.3% according to the CEAC, suggesting that further research may be warranted in order to reduce the level of uncertainty associated with the decision as to whether SRCBT is cost-effective. (C) 2009 Elsevier B.V. All rights reserved.
引用
收藏
页码:158 / 163
页数:6
相关论文
共 41 条
[21]   Representing uncertainty: The role of cost-effectiveness acceptability curves [J].
Fenwick, E ;
Claxton, K ;
Sculpher, M .
HEALTH ECONOMICS, 2001, 10 (08) :779-787
[22]  
FOWLER, PSYCHOL MED IN PRESS, DOI DOI 10.1017/S0033291709005467
[23]  
Glick HA., 2007, Economic Evaluation in Clinical Trials
[24]   Cost-utility of brief psychological treatment for depression and anxiety [J].
Hakkaart-van Roijen, L ;
van Straten, A ;
Rutten, MAF ;
Donker, M .
BRITISH JOURNAL OF PSYCHIATRY, 2006, 188 :323-329
[25]   Predicting the long-term outcome of schizophrenia [J].
Harrison, G ;
Croudace, T ;
Mason, P ;
Glazebrook, C ;
Medley, I .
PSYCHOLOGICAL MEDICINE, 1996, 26 (04) :697-705
[26]   Imputing cross-sectional missing data: comparison of common techniques [J].
Hawthorne, G ;
Elliott, P .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, 2005, 39 (07) :583-590
[27]   A controlled treatment study of somatoform disorders including analysis of healthcare utilization and cost-effectiveness [J].
Hiller, W ;
Fichter, MM ;
Rief, W .
JOURNAL OF PSYCHOSOMATIC RESEARCH, 2003, 54 (04) :369-380
[28]   THE POSITIVE AND NEGATIVE SYNDROME SCALE (PANSS) FOR SCHIZOPHRENIA [J].
KAY, SR ;
FISZBEIN, A ;
OPLER, LA .
SCHIZOPHRENIA BULLETIN, 1987, 13 (02) :261-276
[29]  
Kennedy TM, 2006, HEALTH TECHNOL ASSES, V10, P1
[30]   Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis [J].
Knapp, Martin ;
Thorgrimsen, Lene ;
Patel, Anita ;
Spector, Aimee ;
Hallam, Angela ;
Woods, Bob ;
Orrell, Martin .
BRITISH JOURNAL OF PSYCHIATRY, 2006, 188 :574-580