Cost-effectiveness and cost-utility evaluation of the individual vs. group transdiagnostic psychological treatment for emotional disorders in Primary Care (PsicAP-Costs) v2

2021 ◽  
Author(s):  
Angel Aguilera-Martin ◽  
Mario Gálvez-Lara ◽  
Fátima Cuadrado ◽  
Eliana Moreno ◽  
Francisco García-Torres ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Emotional Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Cognitive Behavioural ◽  
Utility Evaluation ◽  
The Individual

The aim of this study is to compare, in cost-effectiveness and cost-utility terms, a brief transdiagnostic cognitive-behavioural therapy in two different modes, individual and group, with the treatment usually administered in primary care (TAU). Participants between 18 and 65 years old and with, according to the pretreatment evaluation, mild to moderate emotional disorders will be randomly allocated to the three clusters. They will be assessed again immediately after treatment and 6 and 12 months later. ClinicalTrials.gov: NCT04847310

scholarly journals Cost-effectiveness of computerized cognitive–behavioural therapy for the treatment of depression in primary care: findings from the Randomised Evaluation of the Effectiveness and Acceptability of Computerised Therapy (REEACT) trial

2017 ◽  
Vol 47 (10) ◽  
pp. 1825-1835 ◽  
Author(s):  
A. Duarte ◽  
S. Walker ◽  
E. Littlewood ◽  
S. Brabyn ◽  
C. Hewitt ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Scenario Analyses ◽  
Cognitive Behavioural ◽  
Life Years ◽  
Gp Care ◽  
The Cost

BackgroundComputerized cognitive–behavioural therapy (cCBT) forms a core component of stepped psychological care for depression. Existing evidence for cCBT has been informed by developer-led trials. This is the first study based on a large independent pragmatic trial to assess the cost-effectiveness of cCBT as an adjunct to usual general practitioner (GP) care compared with usual GP care alone and to establish the differential cost-effectiveness of a free-to-use cCBT programme (MoodGYM) in comparison with a commercial programme (Beating the Blues) in primary care.MethodCosts were estimated from a healthcare perspective and outcomes measured using quality-adjusted life years (QALYs) over 2 years. The incremental cost-effectiveness of each cCBT programme was compared with usual GP care. Uncertainty was estimated using probabilistic sensitivity analysis and scenario analyses were performed to assess the robustness of results.ResultsNeither cCBT programme was found to be cost-effective compared with usual GP care alone. At a £20 000 per QALY threshold, usual GP care alone had the highest probability of being cost-effective (0.55) followed by MoodGYM (0.42) and Beating the Blues (0.04). Usual GP care alone was also the cost-effective intervention in the majority of scenario analyses. However, the magnitude of the differences in costs and QALYs between all groups appeared minor (and non-significant).ConclusionsTechnically supported cCBT programmes do not appear any more cost-effective than usual GP care alone. No cost-effective advantage of the commercially developed cCBT programme was evident compared with the free-to-use cCBT programme. Current UK practice recommendations for cCBT may need to be reconsidered in the light of the results.

scholarly journals Economic evaluation of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trial

2010 ◽  
Vol 196 (4) ◽  
pp. 310-318 ◽  
Author(s):  
S. A. H. Gerhards ◽  
L. E. de Graaf ◽  
L. E. Jacobs ◽  
J. L. Severens ◽  
M. J. H. Huibers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Significant Group ◽  
Efficient Treatment ◽  
Cognitive Behavioural ◽  
The Cost

BackgroundEvidence about the cost-effectiveness and cost utility of computerised cognitive–behavioural therapy (CCBT) is still limited. Recently, we compared the clinical effectiveness of unsupported, online CCBT with treatment as usual (TAU) and a combination of CCBT and TAU (CCBT plus TAU) for depression. The study is registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN47481236).AimsTo assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU.MethodCosts, depression severity and quality of life were measured for 12 months. Cost-effectiveness and cost-utility analyses were performed from a societal perspective. Uncertainty was dealt with by bootstrap replications and sensitivity analyses.ResultsCosts were lowest for the CCBT group. There are no significant group differences in effectiveness or quality of life. Cost-utility and cost-effectiveness analyses tend to be in favour of CCBT.ConclusionsOn balance, CCBT constitutes the most efficient treatment strategy, although all treatments showed low adherence rates and modest improvements in depression and quality of life.

scholarly journals Cost-effectiveness of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trial

2004 ◽  
Vol 185 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Paul McCrone ◽  
Martin Knapp ◽  
Judith Proudfoot ◽  
Clash Ryden ◽  
Kate Cavanagh ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Quality Adjusted Life Year ◽  
Anxiety And Depression ◽  
Net Benefit ◽  
Cognitive Behavioural

BackgroundCognitive-behavioural therapy (CBT) is effective for treating anxiety and depression in primary care, but there is a shortage of therapists. Computer-delivered treatment may be a viable alternative.AimsTo assess the cost-effectiveness of computer-delivered CBT.MethodA sample of people with depression or anxiety were randomised to usual care (n= 128) or computer-delivered CBT (n= 146). Costs were available for 123 and 138 participants, respectively. Costs and depression scores were combined using the net benefit approach.ResultsService costs were £40 (90% CI-£28 to £148) higher over 8 months for computer-delivered CBT. Lost-employment costs were £407 (90% CI £196 to £586) less for this group. Valuing a 1-unit improvement on the Beck Depression Inventory at £40, there is an 81% chance that computer-delivered CBT is cost-effective, and it revealed a highly competitive cost per quality-adjusted life year.ConclusionsComputer-delivered CBT has a high probability of being cost-effective, even if a modest value is placed on unit improvements in depression.

scholarly journals Economic evaluation of cognitive behavioural therapy for insomnia (CBT-I) for improving health outcomes in adult population: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032176 ◽  
Author(s):  
Andrea Natalie Natsky ◽  
Andrew Vakulin ◽  
Ching Li Chai-Coetzer ◽  
Leon Lack ◽  
R. Doug McEvoy ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Adult Population ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Primary Data ◽  
Economic Evaluations ◽  
Cost Minimisation Analysis ◽  
Cognitive Behavioural

IntroductionInsomnia is associated with a number of adverse consequences that place a substantial economic burden on individuals and society. Cognitive behavioural therapy for insomnia (CBT-I) is a promising intervention that can improve outcomes in people who suffer from insomnia. However, evidence of its cost-effectiveness remains unclear. In this study, we will systematically review studies that report on economic evaluations of CBT-I and investigate the potential economic benefit of CBT-I as a treatment for insomnia.Methods and analysisThe search will include studies that use full economic evaluation methods (ie, cost-effectiveness, cost-utility, cost-benefit, cost-consequences and cost-minimisation analysis) and those that apply partial economic evaluation approaches (ie, cost description, cost-outcome description and cost analysis). We will conduct a preliminary search in MEDLINE, Google Scholar, MedNar and ProQuest dissertation and theses to build the searching terms. A full search strategy using all identified keywords and index terms will then be undertaken in several databases including MEDLINE, Psychinfo, Proquest, Cochrane, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science and EMBASE. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for protocol guidelines in this review. Only articles in the English language and those reporting on adult populations will be included. We will use standardised data extraction tools for economic evaluations to retrieve and synthesise information from selected studies into themes and summarised in a Joanna Briggs Institute dominance ranking matrix.Ethics and disseminationNo formal ethics approval will be required as we will not be collecting primary data. Review findings will be disseminated through a peer-reviewed publication, workshops, conference presentations and a media release.PROSPERO registration numberCRD42019133554.

scholarly journals Cost-effectiveness of internet-based cognitive–behavioural therapy and physical exercise for depression

BJPsych Open ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. 265-273 ◽  
Author(s):  
Martin Kraepelien ◽  
Simon Mattsson ◽  
Erik Hedman-Lagerlöf ◽  
Ingemar F. Petersson ◽  
Yvonne Forsell ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Physical Exercise ◽  
Cognitive Behavioural Therapy ◽  
Service Use ◽  
Controlled Trial ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Life Years

BackgroundBoth internet-based cognitive–behavioural therapy (ICBT) and physical exercise are alternatives to treatment as usual (TAU) in managing mild to moderate depression in primary care.AimsTo determine the cost-effectiveness of ICBT and physical exercise compared with TAU in primary care.MethodEconomic evaluation of a randomised controlled trial (N = 945) in Sweden. Costs were estimated by a service use questionnaire and used together with the effects on quality-adjusted life-years (QALYs). The primary 3-month healthcare provider perspective in primary care was complemented by a 1-year societal perspective.ResultsThe primary analysis showed that incremental cost per QALY gain was €8817 for ICBT and €14 571 for physical exercise compared with TAU. At the established willingness-to-pay threshold of €21 536 (£20 000) per QALY, the probability of ICBT being cost-effective is 90%, and for physical exercise is 76%, compared with TAU.ConclusionsFrom a primary care perspective, both ICBT and physical exercise for depression are likely to be cost-effective compared with TAU.Declaration of interestNone.

scholarly journals HIGHLIGHTS IN THIS ISSUE

2003 ◽  
Vol 33 (2) ◽  
pp. 189-189
Keyword(s):  
Primary Care ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Controlled Trials ◽  
Depression And Anxiety ◽  
Cognitive Behavioural ◽  
Psychodynamic Counselling

Psychological treatment in primary care. This issue features four papers on psychological treatment in primary care. An editorial by Scott & Sensky (pp. 191–196) also discusses the methodology of such studies. Bower et al. (pp. 203–215) report a meta-analysis of controlled trials of counselling. There are benefits but they are modest. Consistent with this, Simpson et al. (pp. 229–239) report a controlled trial of psychodynamic counselling in chronic depression, with little benefit over routine GP treatment. Proudfoot et al. (pp. 217–227) report benefit from an innovative computerized interactive cognitive-behavioural program for depression and anxiety. Gabbay et al. (pp. 241–251) report on agreement on baseline problems between patient, GP and therapist from a controlled comparison of cognitive-behavioural therapy and non-directive counselling.

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