A cost effectiveness analysis of stepped care treatment for bulimia nervosa.
BACKGROUND
The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown.


OBJECTIVE
To examine the cost effectiveness of stepped care treatment for BN.


METHODS
Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behavioral therapy. Cost effectiveness ratios were compared.


RESULTS
The cost per abstinent subject was $12,146 for stepped care, and $20,317 for cognitive behavioral therapy. Quality of life ratings improved significantly with treatment, and family/significant other time burden diminished substantially.


CONCLUSIONS
In this trial, stepped care for BN appeared cost effective in comparison to cognitive behavioral therapy. Treatment was associated with improved quality of life and diminished time costs of illness.
Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota 55454-1495, USA. crowx002@umn.edu
Scott J
SJ
Crow
W Stewart
WS
Agras
Katherine A
KA
Halmi
Christopher G
CG
Fairburn
James E
JE
Mitchell
John A
JA
Nyman
D000328:Adult; D052018:Bulimia Nervosa / Q000188:drug therapy / Q000191:economics / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000191:economics*; D003131:Combined Modality Therapy / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D005473:Fluoxetine / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors