Cost-effectiveness of multidimensional family therapy compared to cognitive behavioral therapy for adolescents with a cannabis use disorder: Data from a randomized controlled trial

被引:18
|
作者
Goorden, M. [1 ,2 ]
van der Schee, E. [3 ]
Hendriks, V. M. [3 ,4 ]
Hakkaart-van Roijena, L. [1 ,2 ]
机构
[1] Erasmus Univ, Inst Med Technol Assessment, POB 1738, NL-3000 DR Rotterdam, Netherlands
[2] Erasmus Univ, Inst Hlth Policy & Management, POB 1738, NL-3000 DR Rotterdam, Netherlands
[3] Parnassia Grp, Brijder Addict Treatment, PARC, POB 53002, The Hague, Netherlands
[4] Leiden Univ, Dept Child & Adolescent Psychiat, Med Ctr, Curium, POB 37, NL-2300 AA Leiden, Netherlands
关键词
Cost-effectiveness; MDFT; CBT; Cannabis use disorder; Adolescents; Delinquency; ISRCTN00179361; SUBSTANCE-ABUSE; MAIN FINDINGS; VALIDITY;
D O I
10.1016/j.drugalcdep.2016.03.004
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Objective: To evaluate the cost-effectiveness of Multidimensional Family Therapy (MDFT) for adolescents with a cannabis use disorder, compared to Cognitive Behavioural Therapy (CBT). Methods: A parallel-group randomized controlled trial was performed. 109 adolescents with a DSM-IV cannabis use disorder (CBT n = 54; MDFT n = 55) were included. Assessments were conducted at baseline, and 3, 6, 9 and 12 months post-baseline, and included measures on cannabis and other substance use, delinquency, health care utilization, and general health related quality of life. Results: Excluding those with missing cost-data, 96 participants (MDFT n=49; CBT n=47) were included. From a health care perspective, the average annual direct medical costs in the CBT group were 2015 (95% C.I. 1397-2714), compared to (sic)5446 (95% CI. 4159-7092) in the MDFT group. The average quality adjusted life years (QALY's) gained were 0.06 QALY higher for the MDFT group, which led to an incremental cost-effectiveness ratio (ICER) of 54,308 Euro/QALY or (sic)43,405 per recovered patient. Taking the costs of delinquency into account, the costs increased to (sic)21,330 (95% C.I. 12,389-32,894) for the CBT group and to (sic)21,915 (95% C.I. 16,273-28,181) for the MDFT group, which lead to an ICER of 9266 Euro/QALY or a cost per recovered patient of (sic)7491. Conclusions: This is the first comprehensive CEA of MDFT compared to CBT and it demonstrated that when costs of delinquency were included, the ICERS were modest. The results underline the importance of adopting a broader perspective regarding cost effectiveness analyses in mental health care. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:154 / 161
页数:8
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