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Doble, Brett, Langdon, Peter E. 
ORCID: https://orcid.org/0000-0002-7745-1825, Shepstone, Lee, Murphy, Glynis H., Fowler, David, Heavens, David, Malovic, Aida, Russell, Alexandra, Rose, Alice, Mullineaux, Louise and Wilson, Edward C. F. ORCID: https://orcid.org/0000-0002-8369-1577
(2017)
Economic evaluation alongside a randomized controlled crossover trial of modified group cognitive–behavioral therapy for anxiety compared to treatment-as-usual in adults with Asperger syndrome.
MDM Policy and Practice, 2 (2).
ISSN 2381-4683
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Abstract
Background: There is a growing interest in using group cognitive–behavioral 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, multicenter, single-blind, randomized controlled crossover 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 £6,647, with only a 0.015 incremental gain in QALYs, leading to a negative INB estimate of £6,206 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 |
|---|---|
| Uncontrolled Keywords: | autism spectrum disorder,cost-effectiveness analysis,psychiatric disorders,value of information,health policy,public health, environmental and occupational health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2719 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Social Sciences > School of Psychology |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Population Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 07 Oct 2023 01:26 |
| Last Modified: | 24 Oct 2023 01:42 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/93183 |
| DOI: | 10.1177/2381468317729353 |
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