title: Befriending carers of people with dementia: a cost utility analysis.
abstract: OBJECTIVE
  There is very little evidence on the cost-effectiveness of social care interventions for people with dementia or their carers. The BEfriending and Costs of CAring trial (BECCA, ISRCTN08130075) aimed to establish whether a structured befriending service improved the quality of life of carers of people with dementia, and at what cost.
  
  
  METHODS
  We performed an economic evaluation alongside a single blind, randomised controlled trial in a community setting of 236 carers of people with a primary progressive dementia. The intervention was contact with a Befriender Facilitator (BF), and offer of match with a trained lay volunteer befriender compared with no BF contact. Main outcome measures were health and social care, voluntary sector, and family care costs and quality adjusted life years (QALYs) in carers over 15 months.
  
  
  RESULTS
  Mean QALYs per carer over 15 months were 0.017 higher in the intervention group compared with control (95%CI: -0.051, 0.083). Mean costs from a societal perspective were pound 1,813 higher (- pound 11,312, pound 14,984). The point estimate Incremental Cost Effectiveness Ratio (ICER) is thus pound 105,954 per incremental QALY gained. Probabilistic sensitivity analysis suggests a 42.2% probability that the ICER is below pound 30,000 per QALY. Inclusion of dementia patient QALYs reduces the ICER to pound 28,848 (51.4% probability below pound 30,000).
  
  
  CONCLUSIONS
  Befriending leads to a non-significant trend towards improved carer quality of life, and there is a non-significant trend towards higher costs for all sectors. It is unlikely that befriending is a cost-effective intervention from the point of view of society.
authors.affiliation: Health Economics Group, School of Medicine, Health Policy and Practice, University of East Anglia, UK. ed.wilson@uea.ac.uk
authors.forename: Edward
authors.initials: E
authors.lastname: Wilson
authors.forename: Mariamma
authors.initials: M
authors.lastname: Thalanany
authors.forename: Lee
authors.initials: L
authors.lastname: Shepstone
authors.forename: Georgina
authors.initials: G
authors.lastname: Charlesworth
authors.forename: Fiona
authors.initials: F
authors.lastname: Poland
authors.forename: Ian
authors.initials: I
authors.lastname: Harvey
authors.forename: David
authors.initials: D
authors.lastname: Price
authors.forename: Shirley
authors.initials: S
authors.lastname: Reynolds
authors.forename: Miranda
authors.initials: M
authors.lastname: Mugford
mesh_terms: D017028:Caregivers / Q000191:economics / Q000523:psychology*; D003365:Costs and Cost Analysis; D003704:Dementia / Q000191:economics* / Q000523:psychology; D005260:Female; D006299:Health Services for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000191:economics*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016037:Single-Blind Method; D012944:Social Support; D006113:United Kingdom