Foruhar Moayeri1, David Dunt1, Ya-Seng Arthur Hsueh1, Colleen Doyle2. 1. a Centre for Health Policy, Melbourne School of Population and Global Health , The University of Melbourne , Carlton Victoria , Australia. 2. b Australian Catholic University, Faculty of Health Sciences , School of Behavioural and Health Sciences (VIC), Villa Maria Catholic Homes , Kew Victoria , Australia.
Abstract
BACKGROUND: This study evaluated the cost-utility of telephone-based cognitive behavioral therapy (TB-CBT) (experimental arm) in comparison with a placebo-befriending (control arm) program in COPD participants with mild to severe depression and/or anxiety. METHODS: The decision rule was based on willingness-to-pay if there is an increased unit of effectiveness (a quality-adjusted life year [QALY] gain) and an increase in cost, and willingness-to-accept (WTA) if there is a reduced unit of effectiveness (a QALY loss) and decrease in cost (a cost-saving). RESULTS: TB-CBT group was associated with a reduction in the incremental cost of AUS-$407.3 (p < 0.001, SE:34.1) plus a negative, nonsignificant incremental QALY gain of -0.008 (SE:0.011) per patient compared to control group. The point estimate of the mean incremental cost-utility ratio was AUS$50,284.0 cost saving per QALY sacrificed (the high value associated with small QALY value in the denominator). Ninety-five percent CI was AUS$13,426 cost sacrificed to AUS$32,018 cost gain (lower values associated with larger QALY values in the denominator). If the societal's minimum (flooring threshold) WTA is AUS$64,000 per QALY forgone, the probability of TB-CBT being cost-effective was 42% Conclusions: This study showed that TB-CBT can be recommended as a cost-saving and preventive approach over usual care plus befriending program.
RCT Entities:
BACKGROUND: This study evaluated the cost-utility of telephone-based cognitive behavioral therapy (TB-CBT) (experimental arm) in comparison with a placebo-befriending (control arm) program in COPDparticipants with mild to severe depression and/or anxiety. METHODS: The decision rule was based on willingness-to-pay if there is an increased unit of effectiveness (a quality-adjusted life year [QALY] gain) and an increase in cost, and willingness-to-accept (WTA) if there is a reduced unit of effectiveness (a QALY loss) and decrease in cost (a cost-saving). RESULTS:TB-CBT group was associated with a reduction in the incremental cost of AUS-$407.3 (p < 0.001, SE:34.1) plus a negative, nonsignificant incremental QALY gain of -0.008 (SE:0.011) per patient compared to control group. The point estimate of the mean incremental cost-utility ratio was AUS$50,284.0 cost saving per QALY sacrificed (the high value associated with small QALY value in the denominator). Ninety-five percent CI was AUS$13,426 cost sacrificed to AUS$32,018 cost gain (lower values associated with larger QALY values in the denominator). If the societal's minimum (flooring threshold) WTA is AUS$64,000 per QALY forgone, the probability of TB-CBT being cost-effective was 42% Conclusions: This study showed that TB-CBT can be recommended as a cost-saving and preventive approach over usual care plus befriending program.
Authors: Jade Schrijver; Anke Lenferink; Marjolein Brusse-Keizer; Marlies Zwerink; Paul Dlpm van der Valk; Job van der Palen; Tanja W Effing Journal: Cochrane Database Syst Rev Date: 2022-01-10
Authors: Marsus I Pumar; Mark Roll; Pamela Fung; Tricia A Rolls; James R Walsh; Rayleen V Bowman; Kwun M Fong; Ian A Yang Journal: J Thorac Dis Date: 2019-10 Impact factor: 2.895