The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial.
Borderline personality disorder places a significant burden on healthcare providers and other agencies. This study evaluated the cost-effectiveness of cognitive behavior therapy plus treatment as usual compared to treatment as usual alone for patients with borderline personality disorder. The economic analysis was conducted alongside a multi-center, randomized controlled trial. The costs of primary and secondary healthcare utilization, alongside the wider economic costs, were estimated from medical records and patient self-report. The primary outcome measure used was the quality-adjusted life year (QALY), assessed using EuroQol. On average, total costs per patient in the cognitive behavior therapy group were lower than patients receiving usual care alone (-689 pounds sterling), although this group also reported a lower quality of life (-0.11 QALYs). These differences were small and did not approach conventional levels of statistical significance. The use of cognitive therapy for borderline personality disorder does not appear to demonstrate any significant cost-effective advantage based on the results of this study.
Palmer
Stephen
S
Centre for Health Economics, University of York. sjp21@york.ac.uk
Davidson
Kate
K
Tyrer
Peter
P
Gumley
Andrew
A
Tata
Philip
P
Norrie
John
J
Murray
Heather
H
Seivewright
Helen
H
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics* / Q000379:methods; D001007:Anxiety / Q000517:prevention & control; D001883:Borderline Personality Disorder / Q000191:economics* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D016728:Self-Injurious Behavior / Q000517:prevention & control; D012917:Social Adjustment; D016896:Treatment Outcome; D000092864:Suicide Prevention