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Cost-effectiveness ...
Cost-effectiveness of internet-delivered cognitive-behavioural therapy for adolescents with irritable bowel syndrome
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- Sampaio, Filipa, PhD, 1985- (author)
- Uppsala universitet,Socialmedicin/CHAP
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- Bonnert, M (author)
- Karolinska Institutet
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- Olen, O (author)
- Karolinska Institutet
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- Hedman, E (author)
- Karolinska Institutet
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- Lalouni, M (author)
- Karolinska Institutet
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- Lenhard, F (author)
- Karolinska Institutet
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- Ljotsson, B (author)
- Karolinska Institutet
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- Ssegonja, Richard (author)
- Uppsala universitet,Socialmedicin/CHAP
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- Serlachius, E (author)
- Karolinska Institutet
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- Feldman, Inna, Docent, 1951- (author)
- Uppsala universitet,Socialmedicin/CHAP
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(creator_code:org_t)
- 2019-01-24
- 2019
- English.
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In: BMJ open. - : BMJ. - 2044-6055. ; 9:1, s. e023881-
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https://doi.org/10.1...
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https://doi.org/10.1...
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Abstract
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- To assess whether exposure-based internet-delivered cognitive–behavioural therapy (internet-CBT) is a cost-effective treatment for adolescents with irritable bowel syndrome (IBS) compared with a waitlist control, from a societal perspective, based on data from a randomised trial.DesignWithin-trial cost-effectiveness analysis.SettingParticipants were recruited from the whole of Sweden via primary, secondary and tertiary care clinics reached through news media and advertising.ParticipantsAdolescents (aged 13–17) with a diagnosis of IBS.InterventionsParticipants were randomised to either an exposure-based internet-CBT, including 10 weekly modules for adolescents and five modules for parents, or a waitlist.Outcome measuresThe main health outcome was the quality-adjusted life-year (QALY) estimated by mapping Pediatric Quality-of-Life Inventory (PedsQL) scores onto EQ-5D-3L utilities. The secondary outcome was the point improvement on the PedsQL scale. Data on health outcomes and resource use were collected at baseline and 10 weeks post-treatment. Resource use was measured using the Trimbos and Institute of Medical Technology Assessment Cost Questionnaire for Psychiatry (TIC-P) . Incremental cost-effectiveness ratios (ICER) were calculated as the difference in average costs by the difference in average outcomes between groups.ResultsThe base-case results showed that internet-CBT costs were on average US$170.24 (95% CI 63.14 to 315.04) more per participant than the waitlist. Adolescents in the internet-CBT group showed small QALY gains (0.0031; 95% CI 0.0003 to 0.0061), and an average improvement of 5.647 points (95% CI 1.82 to 9.46) on the PedsQL compared with the waitlist. Internet-CBT yielded an ICER of $54 916/QALY gained and a probability of cost-effectiveness of 74% given the Swedish willingness-to-pay threshold. The ICER for the outcome PedsQL was US$85.29/point improvement.ConclusionsOffering internet-CBT to adolescents with IBS improves health-related quality of life and generates small QALY gains at a higher cost than a waitlist control. Internet-CBT is thus likely to be cost-effective given the strong efficacy evidence, small QALY gains and low cost.Trial registration numberNCT02306369; Results.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
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- ref (subject category)
- art (subject category)
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Sampaio, Filipa, ...
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Bonnert, M
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Olen, O
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Hedman, E
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Lalouni, M
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Lenhard, F
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Ljotsson, B
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Ssegonja, Richar ...
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Serlachius, E
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Feldman, Inna, D ...
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- MEDICAL AND HEALTH SCIENCES
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BMJ open
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Karolinska Institutet
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Uppsala University