Cost-effectiveness of focal psychodynamic therapy and enhanced cognitive-behavioural therapy in out-patients with anorexia nervosa
Background Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine...
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| Main Authors: | , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
9 September 2016
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| In: |
Psychological medicine
Year: 2016, Volume: 46, Issue: 16, Pages: 3291-3301 |
| ISSN: | 1469-8978 |
| DOI: | 10.1017/S0033291716002002 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1017/S0033291716002002 Verlag, Volltext: https://www.cambridge.org/core/journals/psychological-medicine/article/costeffectiveness-of-focal-psychodynamic-therapy-and-enhanced-cognitivebehavioural-therapy-in-outpatients-with-anorexia-nervosa/491DD18A1362334EE3AB7D5D8AD1691F 
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| Author Notes: | N. Egger, B. Wild, S. Zipfel, F. Junne, A. Konnopka, U. Schmidt, M. de Zwaan, S. Herpertz, A. Zeeck, B. Löwe, J. von Wietersheim, S. Tagay, M. Burgmer, A. Dinkel, W. Herzog, H.-H. König |
| Summary: | Background Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive-behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN. Method The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost-utility and assumptions underlying the base case were investigated in exploratory analyses. Results Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends. Conclusions Depending on the WTP, FPT proved cost-effective in the treatment of adult AN. |
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| Item Description: | Gesehen am 02.11.2017 |
| Physical Description: | Online Resource |
| ISSN: | 1469-8978 |
| DOI: | 10.1017/S0033291716002002 |