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)
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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 |
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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) |
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