Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents.
BACKGROUND
Young people with anorexia nervosa are often admitted to hospital for treatment. As well as being disruptive to school, family and social life, in-patient treatment is expensive, yet cost-effectiveness evidence is lacking.


OBJECTIVE
Cost-effectiveness analysis of three treatment strategies for adolescents with anorexia nervosa.


METHODS
UK multicentre randomised, controlled trial comparing in-patient psychiatric treatment, specialist out-patient treatment and general out-patient treatment. Outcomes and costs assessed at baseline, 1 and 2 years.


RESULTS
There were 167 young people in the trial. There were no statistically significant differences in clinical outcome between the three groups at 2 years. The specialist out-patient group was less costly over the 2-year follow-up (mean total cost 26 738 UK pounds) than the in-patient (34 531 UK pounds) and general out-patient treatment (40 794 UK pounds) groups, but this result was not statistically significant. Exploration of the uncertainty associated with the costs and effects of the three treatments suggests that specialist out-patient treatment has the highest probability of being cost-effective.


CONCLUSIONS
On the basis of cost-effectiveness, these results support the provision of specialist out-patient services for adolescents with anorexia nervosa.
Byford
Sarah
S
Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK. s.byford@iop.kcl.ac.uk
Barrett
Barbara
B
Roberts
Chris
C
Clark
Andrew
A
Edwards
Vanessa
V
Smethurst
Nicola
N
Gowers
Simon G
SG
D000293:Adolescent; D000856:Anorexia Nervosa / Q000191:economics* / Q000628:therapy*; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000191:economics; D003156:Community Mental Health Services / Q000191:economics; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics* / Q000379:methods; D004739:England; D005196:Family Therapy / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data; D006302:Health Services Research; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D010044:Outpatient Clinics, Hospital / Q000191:economics; D013222:State Medicine / Q000191:economics; D016896:Treatment Outcome