Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in chronic arthritis patients.
BACKGROUND
Anxiety disorders are widespread in patients with chronic diseases such as rheumatoid arthritis (RA). This paper targets the cost-effectiveness analysis of a cognitive-behavioral group therapy (CBT) in comparison to a client-centered, supportive-experiential group therapy (SET) in arthritis patients with dysfunctional fear of progression.


METHODS
From the societal perspective, direct costs were compared with the reduction of fear of progression over time. Means, their 95% confidence intervals (95% CI), the incremental cost-effectiveness graphic and the acceptability curve were obtained using 1000 non-parametric bootstrap replications.


RESULTS
A total of 174 RA patients were included in the economic evaluation. The estimated means (95% CI) of direct costs and reduction of fear of progression were, respectively, €7945.34 (5075.59; 11335.08) and 0.25 (-0.48; 0.99) for patients in the SET and 5619.25 € (3950.67; 7708.52) and 0.94 (0.29; 1.62) for patients in the CBT. As the majority of the cost-effect pairs after bootstrap analysis were located in the southeast quadrant of the cost-effectiveness plane, the CBT can be considered a dominant intervention.


CONCLUSIONS
The main result of our study is the higher cost-effectiveness of CBT in comparison to SET in RA patients with dysfunctional fear of progression.
Brach
Mirjam
M
Swiss Paraplegic Research, Postfach CH-6207, Nottwil, Switzerland.
Sabariego
Carla
C
Herschbach
Peter
P
Berg
Petra
P
Engst-Hastreiter
Ursula
U
Stucki
Gerold
G
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005239:Fear / Q000523:psychology*; D005260:Female; D005858:Germany; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged