title: Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients.
abstract: Anxiety and fear are often associated with chronic conditions such as cancer. 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 cancer patients with dysfunctional fear of progression. An incremental cost-effectiveness analysis was performed using data from a randomized controlled trial among cancer patients receiving inpatient rehabilitation. The means, 95% confidence intervals [95% CI], incremental cost-effectiveness graphic and acceptability curve were obtained from 1,000 bootstrap replications. A total of 174 patients were included in the economic evaluation. The estimated means [95% CI] of direct costs and reduction of fear of progression were <euro>9,045.03 [6,359.07; 12,091.87] and 1.41 [0.93; 1.92] for patients in the SET and <euro>6,682.78 [4,998.09; 8,440.95] and 1.44 [1.02; 1.09] for patients in the CBT. The incremental cost-effectiveness ratio [95% CI] amounts to minus <euro>78,741.66 [-154,987.20; 110,486.32] for an additional unit of effect. Given the acceptability curve, there is a 92.4% chance that the CBT, compared with the SET, is cost-effective without the need of additional costs to payers. Our main result is the superior cost-effectiveness of the cognitive-behavioral intervention program in comparison to the non-directive encounter group for our sample of cancer patients with high levels of anxiety.
authors.affiliation: Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-University, Marchioninistraße 17, 81377, Munich, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Sabariego
authors.forename: M
authors.initials: M
authors.lastname: Brach
authors.forename: P
authors.initials: P
authors.lastname: Herschbach
authors.forename: P
authors.initials: P
authors.lastname: Berg
authors.forename: G
authors.initials: G
authors.lastname: Stucki
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005239:Fear / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome