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 SyndromeReport as inadecuate




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Reference: Doble, B, Langdon, PE, Shepstone, L et al., 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.Citable link to this page:

 

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

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 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 £6647, with only a 0.015 incremental 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.

Publication status:AcceptedPeer Review status:Peer reviewedVersion:Accepted ManuscriptDate of acceptance:01 August 2017 Funder: National Institute for Health Research   Notes:This paper has been accepted for publication in MDM Policy and Practice.

Bibliographic Details

Publisher: SAGE

Publisher Website: http://journals.sagepub.com/

Journal: MDM Policy and Practicesee more from them

Publication Website: http://journals.sagepub.com/home/mppIdentifiers

Uuid: uuid:11818535-5849-4533-b1a9-56c64d272b51

Urn: uri:11818535-5849-4533-b1a9-56c64d272b51

Pubs-id: pubs:710151

Issn: 2381-4683

Eissn: 2381-4683 Item Description

Type: journal-article;

Version: Accepted ManuscriptKeywords: autism spectrum disorder cost-effectiveness analysis psychiatric disorders value of information

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Author: Doble, B - Oxford, MSD, Nuffield Dept of Population Health, POPULATION HEALTH - - - Langdon, PE - - - Shepstone, L - - - Murphy,

Source: https://ora.ox.ac.uk/objects/uuid:11818535-5849-4533-b1a9-56c64d272b51



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