Cost-effectiveness of cognitive behaviour therapy in addition to mebeverine for irritable bowel syndrome.
OBJECTIVE
Irritable bowel syndrome is often treated in primary-care settings, and it has a relatively large economic impact. Cognitive behaviour therapy (CBT) in addition to mebeverine has been shown to be effective in the short term, compared with treatment with mebeverine alone. This study assesses the impact that CBT in addition to mebeverine has on resource use, and its cost-effectiveness.


METHODS
Participants were recruited from general practices: those with ongoing symptoms were randomly allocated either to remain just on mebeverine or to receive CBT in addition to mebeverine. Service use and lost employment were measured at baseline and at the 3-month, 6-month and 12-month follow-ups. The net-benefit approach was used for combining the data on therapy costs and symptoms.


RESULTS
The mean additional cost of CBT was pound 308. No significant impact of CBT on the use of other services or on lost employment was noted. The cost per clinically important reduction in symptoms was pound 220 by the end of treatment, pound 171 at the 3-month follow-up, pound 1027 at the 6-month follow-up and pound 3080 at the 12-month follow-up, for CBT in addition to mebeverine compared with mebeverine alone.


CONCLUSIONS
CBT in addition to mebeverine seems to have reasonable cost-effectiveness in the short-term treatment of irritable bowel syndrome, but not beyond 3 months.
McCrone
Paul
P
Health Services Research Department, Centre for the Economics of Mental Health, School of Medicine, King's College, London, UK. p.mccrone@iop.kcl.ac.uk
Knapp
Martin
M
Kennedy
Tom
T
Seed
Paul
P
Jones
Roger
R
Darnley
Simon
S
Chalder
Trudie
T
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000191:economics / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000191:economics* / Q000379:methods; D003131:Combined Modality Therapy / Q000191:economics; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010627:Phenethylamines / Q000191:economics / Q000627:therapeutic use*; D011320:Primary Health Care / Q000191:economics; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D016896:Treatment Outcome
D000927:Anticonvulsants; D010627:Phenethylamines; C005096:mebeverine