Cost-effectiveness of guided self-help treatment for recurrent binge eating.
OBJECTIVE
Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits. Using data from a recent randomized controlled trial, we conducted an incremental cost-effectiveness analysis (CEA) of a cognitive-behavioral therapy guided self-help intervention (CBT-GSH) to treat recurrent binge eating compared to treatment as usual (TAU).


METHODS
Participants were 123 adult members of an HMO (mean age = 37.2 years, 91.9% female, 96.7% non-Hispanic White) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination (C. G. Fairburn & Z. Cooper, 1993). Participants were randomized either to treatment as usual (TAU) or to TAU plus CBT-GSH. The clinical outcomes were binge-free days and quality-adjusted life years (QALYs); total societal cost was estimated using costs to patients and the health plan and related costs.


RESULTS
Compared to those receiving TAU only, those who received TAU plus CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $427 over 12 months following the intervention (incremental CEA ratio of -$20.23 per binge-free day or -$26,847 per QALY). Lower costs in the TAU plus CBT-GSH group were due to reduced use of TAU services in that group, resulting in lower net costs for the TAU plus CBT group despite the additional cost of CBT-GSH.


CONCLUSIONS
Findings support CBT-GSH dissemination for recurrent binge-eating treatment.
Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA. frances.lynch@kpchr.org
Frances L
FL
Lynch
Ruth H
RH
Striegel-Moore
John F
JF
Dickerson
Nancy
N
Perrin
Lynn
L
Debar
G Terence
GT
Wilson
Helena C
HC
Kraemer
D000328:Adult; D000856:Anorexia Nervosa / Q000191:economics / Q000628:therapy; D056912:Binge-Eating Disorder / Q000191:economics* / Q000628:therapy*; D052018:Bulimia Nervosa / Q000191:economics / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D017046:Cost Savings / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D008370:Manuals as Topic; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D055502:Secondary Prevention; D012648:Self Care / Q000191:economics*