scholarly journals Cost-utility of brief psychological treatment for depression and anxiety

2006 ◽  
Vol 188 (4) ◽  
pp. 323-329 ◽  
Author(s):  
Leona Hakkaart-Van Roijen ◽  
Annemieke Van Straten ◽  
Maiwenn Al ◽  
Frans Rutten ◽  
Marianne Donker
Keyword(s):  
Brief Therapy ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Indirect Costs ◽  
Direct Costs ◽  
Cost Utility ◽  
Depression And Anxiety ◽  
Treatment Groups ◽  
Life Years ◽  
The Cost

BackgroundThe cost-utility of brief therapy compared with cognitive–behavioural therapy (CBT) and care as usual in the treatment of depression and anxiety has not yet been determined.AimsTo assess the cost-utility of brief therapy compared with CBT and care as usual.MethodA pragmatic randomised controlled trial involving 702 patients was conducted at 7 Dutch mental healthcare centres (MHCs). Patients were interviewed at baseline and then every 3 months over a period of 1.5 years, during which time data were collected on direct costs, indirect costs and quality of life.ResultsThe mean direct costs of treatment at the MHCs were significantly lower for brief therapy than for CBT and care as usual. However, after factoring in other healthcare costs and indirect costs, no significant differences between the treatment groups could be detected. We found no significant differences in quality-adjusted life-years between the groups.ConclusionsCost-utility did not differ significantly between the three treatment groups.

scholarly journals Cost–Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study)

2019 ◽  
Vol 8 (7) ◽  
pp. 1068 ◽  
Author(s):  
Adrián Pérez-Aranda ◽  
Francesco D’Amico ◽  
Albert Feliu-Soler ◽  
Lance M. McCracken ◽  
María T. Peñarrubia-María ◽  
...  
Keyword(s):  
Stress Reduction ◽  
Controlled Trial ◽  
Indirect Costs ◽  
Cost Utility ◽  
Public Healthcare ◽  
Quality Adjusted Life Years ◽  
Randomized Controlled ◽  
Life Years ◽  
The Cost ◽  
Quality Adjusted Life

Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost–utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (“FibroQoL”) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost–utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (ΔQALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context.

scholarly journals Cost-Utility of Attachment-Based Compassion Therapy (ABCT) for Fibromyalgia Compared to Relaxation: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 9 (3) ◽  
pp. 726 ◽  
Author(s):  
Francesco D’Amico ◽  
Albert Feliu-Soler ◽  
Jesús Montero-Marín ◽  
María T. Peñarrubía-María ◽  
Mayte Navarro-Gil ◽  
...  
Keyword(s):  
Incremental Cost ◽  
Healthcare Costs ◽  
Service Use ◽  
Controlled Trial ◽  
Cost Utility ◽  
Small Sample ◽  
Incremental Effect ◽  
Life Years ◽  
The Cost

A recent study has supported the efficacy of Attachment-Based Compassion Therapy (ABCT) compared to relaxation (REL) for the management of fibromyalgia (FM). The main objective of this paper is to examine the cost-utility of ABCT compared to REL in terms of effects on quality-adjusted life years (QALYs) as well as healthcare costs. Forty-two Spanish patients with FM received 8 weekly group sessions of ABCT or REL. Data collection took place at pre- and 3-month follow-up. Cost-utility of the two treatment groups (ABCT vs. REL) was compared by examining treatment outcomes in terms of QALYs (obtained with the EQ-5D-3L) and healthcare costs (data about service use obtained with the Client Service Receipt Inventory). Data analyses were computed from a completers, ITT, and per protocol approach. Data analysis from the healthcare perspective revealed that those patients receiving ABCT exhibited larger improvements in quality of life than those doing relaxation, while being less costly 3 months after their 8-week treatment program had ended (completers: incremental cost M, 95% CI = €−194.1 (−450.3 to 356.1); incremental effect M, 95% CI = 0.023 QALYs (0.010 to 0.141)). Results were similar using an ITT approach (incremental cost M, 95% CI = €−256.3 (−447.4 to −65.3); incremental effect M, 95% CI = 0.021 QALYs (0.009 to 0.033)). A similar pattern of results were obtained from the per protocol approach. This RCT has contributed to the evidence base of compassion-based interventions and provided useful information about the cost-utility of ABCT for FM patients when compared to relaxation. However, the small sample size and short follow-up period limited the generalizability of the findings.

scholarly journals Cost-effectiveness of surgical treatments compared with early structured physiotherapy in secondary care for adults with primary frozen shoulder

2021 ◽  
Vol 2 (8) ◽  
pp. 685-695
Author(s):  
Belen Corbacho ◽  
Stephen Brealey ◽  
Ada Keding ◽  
Gerry Richardson ◽  
David Torgerson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Secondary Care ◽  
Controlled Trial ◽  
Frozen Shoulder ◽  
Cost Effective ◽  
Cost Utility ◽  
Sensitivity Analyses ◽  
Arthroscopic Capsular Release ◽  
Life Years ◽  
The Cost

Aims A pragmatic multicentre randomized controlled trial, UK FROzen Shoulder Trial (UK FROST), was conducted in the UK NHS comparing the cost-effectiveness of commonly used treatments for adults with primary frozen shoulder in secondary care. Methods A cost utility analysis from the NHS perspective was performed. Differences between manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR), and early structured physiotherapy plus steroid injection (ESP) in costs (2018 GBP price base) and quality adjusted life years (QALYs) at one year were used to estimate the cost-effectiveness of the treatments using regression methods. Results ACR was £1,734 more costly than ESP ((95% confidence intervals (CIs) £1,529 to £1,938)) and £1,457 more costly than MUA (95% CI £1,283 to £1,632). MUA was £276 (95% CI £66 to £487) more expensive than ESP. Overall, ACR had worse QALYs compared with MUA (-0.0293; 95% CI -0.0616 to 0.0030) and MUA had better QALYs compared with ESP (0.0396; 95% CI -0.0008 to 0.0800). At a £20,000 per QALY willingness-to-pay threshold, MUA had the highest probability of being cost-effective (0.8632) then ESP (0.1366) and ACR (0.0002). The results were robust to sensitivity analyses. Conclusion While ESP was less costly, MUA was the most cost-effective option. ACR was not cost-effective. Cite this article: Bone Jt Open 2021;2(8):685–695.

PP048 Quality Of Health Care Through Integration: Experience Of Cochlear Implantation

2017 ◽  
Vol 33 (S1) ◽  
pp. 93-94
Author(s):  
Lyazzat Kosherbayeva ◽  
Aigul Medeulova ◽  
Abdulla Alzhanov
Keyword(s):  
Health Care ◽  
Healthcare System ◽  
Cochlear Implantation ◽  
Cost Utility ◽  
Economic Research ◽  
Rehabilitation Programs ◽  
Life Years ◽  
The Republic ◽  
The Cost

INTRODUCTION:The State Program for Health Development of the Republic of Kazakhstan (RK) “Densaulyk” for 2016–2019 initiated the modernization of primary health care with the introduction of family practice in order to ensure the availability, completeness and quality of health services on the basis of an integrated healthcare system focused on the needs of the population. The aim of this study was to determine the effectiveness of the cochlear implantation (CI) programs.METHODS:A literature search was conducted for all clinical trials, randomized controlled trials, and reviews in the PubMed, Cochrane, and Center for Reviews and Dissemination databases. Two reviewers independently evaluated all publications for selection. The analysis included the cost-effectiveness and benefit from the CI program.RESULTS:We analyzed the effectiveness of the services for CI in the RK and other countries (1). In our analysis, we identified that there is no research on Quality-adjusted Life Years (QALYs) and Cost-Utility Analysis (CUA) in RK. We found that, in general, the cost of CI and pre-surgical procedures are comparable with other countries. The length of stay in Kazakhstan was much higher (an average of 8 days) compared with other countries (3 days). Also in RK, there were significantly lower prices per hospital day and cost of various consultations. Postoperative costs of other countries consisted of one-third to two-thirds of the total costs for preoperative and implantation stages (2, 3). There was a little information on the effectiveness of rehabilitation programs in RK.CONCLUSIONS:Economic research like QALYs and CUA are new directions in the healthcare system in the RK. Lack of integration between primary care, rehabilitation and other services leads to difficulties in assessing the effectiveness of CI programs (for example, in our case, there was the restriction of assessment in only postoperative costs).

scholarly journals Funding the New Biologics – CCOHTA Report on the Cost Effectiveness of Infliximab for Crohn’s Disease: Pearls and Pitfalls

2002 ◽  
Vol 16 (12) ◽  
pp. 877-879 ◽  
Author(s):  
John K Marshall
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Economic Analysis ◽  
Safety Data ◽  
Cost Utility ◽  
Sensitivity Analyses ◽  
State Transitions ◽  
Health State ◽  
Life Years ◽  
The Cost

The Canadian Coordinating Office for Health Technology Assessment (CCOHTA) published an economic analysis, using a Markov model, of infliximab therapy for Crohn’s disease that is refractory to other treatments. This was the first fully published economic analysis that addresses this treatment option. Health state transitions were based on data from Olmsted County, Minnesota, health state resource profiles were created using expert opinion and a number of assumptions were made when designing the model. The analysis was rigorous, the best available efficacy and safety data were used, state-of-the art sensitivity analyses were undertaken and an ‘acceptability curve‘ was constructed. The model found that infliximab was effective in increasing quality-adjusted life years when offered in a variety of protocols, but it was associated with high incremental cost utility ratios compared with usual care. The results should be interpreted, however, in view of a number of limitations. The time horizon for the analysis was short (one year), because of a lack of longer-term efficacy data, and might have led to an underestimation of the benefits from averting surgery. Because the analysis was performed from the perspective of a Canadian provincial ministry of health, only direct medical costs were considered. Patients with active Crohn’s disease are likely to incur significant indirect costs, which could be mitigated by this medication. The analysis should be updated as new data become available. Moreover, small changes in the cost of the medication could make the treatment cost effective, according to this model. Economic analyses, such as the one undertaken by the CCOHTA, cannot by themselves solve dilemmas in the allocation of limited health care resources, and other considerations must be included when formulating policy. This is especially important for patients with severe Crohn’s disease, who have significant disability and for whom few therapeutic options exist.

scholarly journals Cost-utility of venoarterial extracorporeal membrane oxygenation in cardiogenic shock and cardiac arrest

2020 ◽  
Vol 9 (4) ◽  
pp. 333-341
Author(s):  
Salla Jäämaa-Holmberg ◽  
Birgitta Salmela ◽  
Raili Suojaranta ◽  
Karl B Lemström ◽  
Jyri Lommi
Keyword(s):  
Cardiac Arrest ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Cost Utility ◽  
Quality Adjusted Life Years ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Life Years ◽  
The Cost ◽  
Quality Adjusted Life

Background: The use of venoarterial extracorporeal membrane oxygenation in cardiogenic shock keeps increasing, but its cost-utility is unknown. Methods: We studied retrospectively the cost-utility of venoarterial extracorporeal membrane oxygenation in a five-year cohort of consequent patients treated due to refractory cardiogenic shock or cardiac arrest in a transplant centre in 2013–2017. In our centre, venoarterial extracorporeal membrane oxygenation is considered for all cardiogenic shock patients potentially eligible for heart transplantation, and for selected postcardiotomy patients. We assessed the costs of the index hospitalization and of the one-year hospital costs, and the patients’ health-related quality of life (response rate 71.7%). Based on the data and the population-based life expectancies, we calculated the amount and the costs of quality-adjusted life years gained both without discount and with an annual discount of 3.5%. Results: The cohort included 102 patients (78 cardiogenic shock; 24 cardiac arrest) of whom 67 (65.7%) survived to discharge and 66 (64.7%) to one year. The effective costs per one hospital survivor were 242,303€. Median in-hospital costs of the index hospitalization per patient were 129,967€ (interquartile range 150,340€). Mean predicted number of quality-adjusted life years gained by the treatment was 20.9 (standard deviation 9.7) without discount, and the median cost per quality-adjusted life year was 7474€ (interquartile range 10,973€). With the annual discount of 3.5%, 13.0 (standard deviation 4.8) quality-adjusted life years were gained with the cost of 12,642€ per quality-adjusted life year (interquartile range 15,059€). Conclusions: We found the use of venoarterial extracorporeal membrane oxygenation in refractory cardiogenic shock and cardiac arrest justified from the cost-utility point of view in a transplant centre setting.

scholarly journals Electroacupuncture with Usual Care for Patients with Non-Acute Pain after Back Surgery: Cost-Effectiveness Analysis Alongside a Randomized Controlled Trial

2020 ◽  
Vol 12 (12) ◽  
pp. 5033
Author(s):  
NamKwen Kim ◽  
Kyung-Min Shin ◽  
Eun-Sung Seo ◽  
Minjung Park ◽  
Hye-Yoon Lee
Keyword(s):  
Cost Effectiveness ◽  
Usual Care ◽  
Societal Perspective ◽  
National Health ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Acute Low Back Pain ◽  
Life Years ◽  
Back Surgery ◽  
The Cost

Electroacupuncture (EA) is used to treat pain after back surgery. Although this treatment is covered by national health insurance in Korea, evidence supporting its cost-effectiveness and contribution to the sustainability of the national health care system has yet to be published. Therefore, an economic evaluation, alongside a clinical trial, was conducted to estimate the cost-effectiveness of EA and usual care (UC) versus UC alone to treat non-acute low back pain (LBP). In total, 108 patients were recruited and randomly assigned to treatment groups; 106 were included in the final cost utility analysis. The incremental cost-effectiveness ratio of EA plus UC was estimated as 7,048,602 Korean Rate Won (KRW) per quality-adjusted life years (QALYs) from the societal perspective (SP). If the national threshold was KRW 30 million per QALY, the cost-effectiveness probability of EA plus UC was an estimated 85.9%; and, if the national threshold was over KRW 42,496,372 per QALY, the cost-effectiveness probability would be over 95% percent statistical significance. Based on these results, EA plus UC combination therapy for patients with non-acute LBP may be cost-effective from a societal perspective in Korea.

scholarly journals Social Support—A Protective Factor for Depressed Perinatal Women?

2019 ◽  
Vol 16 (8) ◽  
pp. 1426 ◽  
Author(s):  
Jeannette Milgrom ◽  
Yafit Hirshler ◽  
John Reece ◽  
Charlene Holt ◽  
Alan W. Gemmill
Keyword(s):  
Social Support ◽  
Child Development ◽  
Protective Factor ◽  
Perinatal Depression ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Late Pregnancy ◽  
Antenatal Depression ◽  
Depression And Anxiety ◽  
Perinatal Women

Social support before and after childbirth is a possible protective factor for perinatal depression. Currently, there is a lack of longitudinal studies beyond the first year postpartum exploring the relationship of social support with depression and anxiety. Social support is also a possible protective factor for adverse child development, which is a known consequence of perinatal depression. The present study followed up a cohort of depressed women (n = 54) from a randomised controlled trial of psychological treatment for antenatal depression. We examined the trajectory of the relationships between perceived social support (Social Provisions Scale), depression (Beck Depression Inventory), and anxiety (Beck Anxiety Inventory) twice in pregnancy and twice postpartum up to two years. The influence of social support on child development and parenting-related stress was also explored. Two aspects of social support, Reassurance of Worth and Reliable Alliance, were strongly related to perinatal depression and anxiety, particularly when predicting symptoms in late pregnancy. However, the effect of postnatal depression on child development at 9 and 24 months post-birth was not mediated by social support. These results suggest the importance of adjusting current interventions for depressed perinatal women to focus on social support in late pregnancy and the first six months postpartum.

scholarly journals A Randomized Controlled Trial of the Cost-Utility of Second-Generation Antipsychotics in People with Psychosis and Eligible for Clozapine

2008 ◽  
Vol 11 (4) ◽  
pp. 549-562 ◽  
Author(s):  
Linda M. Davies ◽  
Thomas R.E. Barnes ◽  
Peter B. Jones ◽  
Shôn Lewis ◽  
Fiona Gaughran ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Second Generation ◽  
Controlled Trial ◽  
Cost Utility ◽  
Randomized Controlled ◽  
Second Generation Antipsychotics ◽  
The Cost

Impact of bovine respiratory disease (BRD) from the perspective of the Canadian beef producer

2009 ◽  
Vol 10 (2) ◽  
pp. 109-110 ◽  
Author(s):  
Kee Jim
Keyword(s):  
Respiratory Disease ◽  
Bovine Respiratory Disease ◽  
Indirect Costs ◽  
Direct Costs ◽  
Production Costs ◽  
Direct And Indirect Costs ◽  
Carcass Disposal ◽  
The Cost

AbstractThe costs of bovine respiratory disease (BRD) to the beef producer can be estimated by identifying and summing the direct and indirect costs associated with the disease. The major direct costs are attributable to the cost of the feeder, production costs and carcass disposal. The indirect costs are mainly associated with infrastructure and labour.

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