Cost-utility analysis of transdiagnostic cognitive behavioural therapy for people with persistent physical symptoms in contact with specialist services evaluated in the PRINCE secondary trial

TY - JOUR

T1 - Cost-utility analysis of transdiagnostic cognitive behavioural therapy for people with persistent physical symptoms in contact with specialist services evaluated in the PRINCE secondary trial

AU - McCrone, Paul

AU - Patel , Meenal

AU - Hotopf, Matthew

AU - Moss-Morris, Rona

AU - Ashworth, Mark

AU - David, Anthony S

AU - Husain, Mujtaba

AU - James, Kirsty

AU - Landau, Sabine

AU - Chalder, Trudie

PY - 2024/10/15

Y1 - 2024/10/15

N2 - 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. MethodsThis 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. ResultsThe 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. ConclusionAdding 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.

AB - 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. MethodsThis 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. ResultsThe 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. ConclusionAdding 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.

KW - cost-utility

KW - economic evaluation

KW - cognitive behavioural therapy

KW - persistent physical symptoms

M3 - Article

JO - Journal of Psychosomatic Medicine

JF - Journal of Psychosomatic Medicine

ER -