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Economic Evaluation alongside a Randomised Controlled Crossover Trial of Modified Group Cognitive Behavioural Therapy for Anxiety Compared to Treatment-as-Usual in Adults with Asperger Syndrome

Doble, B, Langdon, Peter E., Shepstone, Lee, Murphy, Glynis H., Fowler, David, Heavens, David, Russell, Alexandra, Mullineaux, Louise, Wilson, Edward C. F. (2017) Economic Evaluation alongside a Randomised Controlled Crossover Trial of Modified Group Cognitive Behavioural Therapy for Anxiety Compared to Treatment-as-Usual in Adults with Asperger Syndrome. MDM Policy and Practice, 2 (2). ISSN 2381-4683. (KAR id:62515)

Abstract

Background: There is a growing interest in using group cognitive behavioural therapy (CBT) with people who have Asperger Syndrome (AS) and comorbid mental health problems. This study aims to assess the cost-effectiveness of modified group CBT for adults with AS experiencing co-occurring anxiety compared to treatment-as-usual.

Methods: Economic evaluation alongside a pilot, multi-centre, single-blind, randomised controlled trial. Costs from the UK public sector (National Health Service and Social Services) and societal perspectives, quality-adjusted life-years (QALYs), incremental net (monetary) benefit (INB), expected value of perfect information, expected value of sample information, expected net gain of sampling, and efficient sample size of a future trial are reported.

Results: Over 48 weeks, from the societal perspective, CBT results in additional costs of £6647, with only a 0.015 gain in QALYs, leading to a negative INB estimate of £6206 and a 23% probability of cost-effectiveness at a threshold of £30,000/QALY. Results from sensitivity analyses support the unlikely cost-effectiveness of CBT, but indicate the potential for cost-effectiveness over longer time horizons. Eliminating decision uncertainty is valued at £277 million and the efficient sample size for a future trial is estimated at 1,200 participants per arm.

Limitations: Relatively small sample size and prevalence of missing data present challenges to the interpretation of the results.

Conclusions: Current evidence from this small pilot study suggests that on average, modified group CBT is not cost-effective. However, there is much decision uncertainty so such a conclusion could be wrong. A large, full scale trial to reduce uncertainty would be an efficient investment for the UK health economy.

Item Type: Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Tizard
Funders: [37325] UNSPECIFIED
Depositing User: Peter Langdon
Date Deposited: 01 Aug 2017 21:22 UTC
Last Modified: 05 Nov 2024 10:57 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/62515 (The current URI for this page, for reference purposes)

University of Kent Author Information

Langdon, Peter E..

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Murphy, Glynis H..

Creator's ORCID: https://orcid.org/0000-0001-7817-5861
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