Cost-effectiveness of an internet-based booster program for patients with obsessive-compulsive disorder: Results from a randomized controlled trial
Cost-effectiveness of an internet-based booster program for patients with obsessive-compulsive disorder: Results from a randomized controlled trial
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DOI：
10.1016/j.jocrd.2014.10.002
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发表时间：
2015-01-01
影响因子：
1.8
通讯作者：
Ruck, Christian
中科院分区：
文献类型：
--
作者：
Andersson, Erik;Ljotsson, Brjann;Ruck, Christian
认知行为疗法（CBT）是一种有效的治疗强迫症时，提供面对面，在小组格式，也通过互联网。然而，尽管总体效应量很大，但相当数量的患者会复发。有可能降低这些复发率的一种干预措施是加强方案，但加强方案是否是预防复发的具有成本效益的方法仍然是未知的。我们使用了最近一项随机对照试验的健康经济数据，在该试验中，接受过基于互联网的CBT的患者被随机分配接受额外的助推程序。评估点为4个月、7个月、12个月和24个月。卫生经济数据主要是从社会角度进行分析的。结果表明，加强方案在预防复发方面是有效的，避免一次复发的成本估计为1066 -1489美元。成本效益可接受性曲线表明，助推器计划有90%的可能性是成本效益的第一年愿意支付1000 -1050美元，但这一数字大大增加后两年（2500 -5500美元）。我们的结论是，基于互联网的助推程序可能是一个具有成本效益的替代方案在一年的时间框架内，可能需要更多的治疗，以保持足够的成本效益长达两年。(C)2014 Elsevier Inc. All rights reserved.
Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066-1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000-1050 the first year, but this figure grew considerably after two years ($2500-5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years. (C) 2014 Elsevier Inc. All rights reserved.