McCrone, Paul ORCID: https://orcid.org/0000-0001-7001-4502, Patel, Meenal, Hotopf, Matthew, Moss-Morris, Rona, Ashworth, Mark, David, Anthony S., Husain, Mujtaba, James, Kirsty, Landau, Sabine and Chalder, Trudie (2024) 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. Journal of Psychosomatic Research, 187:111960. ISSN 0022-3999 (Print), 1879-1360 (Online) (doi:10.1016/j.jpsychores.2024.111960)

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Abstract

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.
Methods: This 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.

Results: The 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.
Conclusion: Adding 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.

Item Type:	Article
Uncontrolled Keywords:	cost-utility, economic evaluation, cognitive behavioural therapy, persistent physical symptoms
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Mental Health Faculty of Education, Health & Human Sciences > School of Health Sciences (HEA)
Last Modified:	20 Nov 2024 10:17
URI:	http://gala.gre.ac.uk/id/eprint/48303

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