Scott J Crow1, John A Nyman. 1. Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota 55454, USA. crowx002@umn.edu
Abstract
OBJECTIVE: Anorexia nervosa (AN) is an expensive-to-treat illness with a high mortality rate. Some health care systems have limited the amount of treatment provided for AN despite the lack of clearly documented efficacy for these limited-intensity approaches. One method that can inform decisions about AN treatment is cost-effectiveness analysis. METHOD: Cost-modeling analysis was used to estimate the incremental cost-effectiveness of AN treatment. Modeling was chosen given the lack of primary data on costs and outcomes in AN treatment. Data for age of onset, life expectancy, and disease-associated mortality were taken from the literature. The costs of treatment used in the analysis were those in use at the University of Minnesota. RESULTS: Assuming an approach consisting of inpatient weight restoration, followed by treatment of gradually diminishing intensity (partial hospitalization, then outpatient psychotherapy plus medication management), incremental cost-effectiveness ratios were calculated and compared with a limited intensity, "usual care" model. These assumptions yielded a cost per year of life saved of 30,180 dollars. DISCUSSION: Relative to many other medical interventions, the comprehensive treatment of AN appears to be quite cost-effective in terms of cost per year of life saved. Such data may have an impact on payer decisions and underscore the serious nature of AN. Copyright 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 155-160, 2004.
OBJECTIVE:Anorexia nervosa (AN) is an expensive-to-treat illness with a high mortality rate. Some health care systems have limited the amount of treatment provided for AN despite the lack of clearly documented efficacy for these limited-intensity approaches. One method that can inform decisions about AN treatment is cost-effectiveness analysis. METHOD: Cost-modeling analysis was used to estimate the incremental cost-effectiveness of AN treatment. Modeling was chosen given the lack of primary data on costs and outcomes in AN treatment. Data for age of onset, life expectancy, and disease-associated mortality were taken from the literature. The costs of treatment used in the analysis were those in use at the University of Minnesota. RESULTS: Assuming an approach consisting of inpatient weight restoration, followed by treatment of gradually diminishing intensity (partial hospitalization, then outpatient psychotherapy plus medication management), incremental cost-effectiveness ratios were calculated and compared with a limited intensity, "usual care" model. These assumptions yielded a cost per year of life saved of 30,180 dollars. DISCUSSION: Relative to many other medical interventions, the comprehensive treatment of AN appears to be quite cost-effective in terms of cost per year of life saved. Such data may have an impact on payer decisions and underscore the serious nature of AN. Copyright 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 155-160, 2004.
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