title: Cost-effectiveness of psychotherapy for cluster B personality disorders.
abstract: BACKGROUND
  Recommendations on current clinical guidelines are informed by limited economic evidence.
  
  
  OBJECTIVE
  A formal economic evaluation of three modalities of psychotherapy for patients with cluster B personality disorders.
  
  
  METHODS
  A probabilistic decision-analytic model to assess the cost-effectiveness of out-patient, day hospital and in-patient psychotherapy over 5 years in terms of cost per recovered patient-year and cost per quality-adjusted life-year (QALY). Analyses were conducted from both societal and payer perspectives.
  
  
  RESULTS
  From the societal perspective, the most cost-effective choice switched from out-patient to day hospital psychotherapy at a threshold of 12,274 euros per recovered patient-year; and from day hospital to in-patient psychotherapy at 113,298 euros. In terms of cost per QALY, the optimal strategy changed at 56,325 euros and 286,493 euros per QALY respectively. From the payer perspective, the switch points were at 9895 euros and 155,797 euros per recovered patient-year, and 43,427 euros and 561,188 euros per QALY.
  
  
  CONCLUSIONS
  Out-patient psychotherapy and day hospital psychotherapy are the optimal treatments for patients with cluster B personality disorders in terms of cost per recovered patient-year and cost per QALY.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands. Djora.Soeteman@deviersprong.nl
authors.forename: Djøra I
authors.initials: DI
authors.lastname: Soeteman
authors.forename: Roel
authors.initials: R
authors.lastname: Verheul
authors.forename: Jos
authors.initials: J
authors.lastname: Delimon
authors.forename: Anke M M A
authors.initials: AM
authors.lastname: Meerman
authors.forename: Ellen
authors.initials: E
authors.lastname: van den Eijnden
authors.forename: Bert V
authors.initials: BV
authors.lastname: Rossum
authors.forename: Uli
authors.initials: U
authors.lastname: Ziegler
authors.forename: Moniek
authors.initials: M
authors.lastname: Thunnissen
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003631:Day Care, Medical / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D009426:Netherlands; D010044:Outpatient Clinics, Hospital / Q000191:economics; D010554:Personality Disorders / Q000191:economics / Q000628:therapy*; D011613:Psychotherapy / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome; D055815:Young Adult