Comparing the cost effectiveness of psychiatric treatments: bulimia nervosa.
We conducted an exploratory post hoc study that compared the cost effectiveness of five treatments for bulimia nervosa: 15 weeks of cognitive behavioral therapy (CB) followed by three monthly sessions, 16 weeks (Med16) and 24 weeks (Med24) of desipramine (< or = 300 mg/day), and CB combined with desipramine for those durations (Combo16 and Combo24). We illustrate how a treatment's cost effectiveness varies according to when evaluation is done and how effectiveness and cost are defined. At 32 weeks, Med16 appears the most cost-effective treatment, and Combo16 appears the least. At 1 year, Med24 appears the most cost-effective treatment, and Combo16 appears the least. Using this post hoc analysis as an example, we discuss the pitfalls and limitations of cost-effectiveness analysis of psychiatric treatments.
Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, CA 94305, USA.
L M
LM
Koran
W S
WS
Agras
E M
EM
Rossiter
B
B
Arnow
J A
JA
Schneider
C F
CF
Telch
S
S
Raeburn
B
B
Bruce
M
M
Perl
H C
HC
Kraemer
D000293:Adolescent; D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D002032:Bulimia / Q000191:economics* / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003891:Desipramine / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D003891:Desipramine