title: Cost-effectiveness of an adjustment group for people with multiple sclerosis and low mood: a randomized trial.
abstract: OBJECTIVE
  To evaluate the cost effectiveness of a psychological adjustment group shown to be clinically effective in comparison with usual care for people with multiple sclerosis.
  
  
  METHODS
  Randomized controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio.
  
  
  METHODS
  Community.
  
  
  METHODS
  People with multiple sclerosis were screened on the General Health Questionnaire 12 and Hospital Anxiety and Depression Scale, and those with low mood were recruited.
  
  
  METHODS
  Participants randomly allocated to the adjustment group received six group treatment sessions. The control group received usual care, which did not include psychological interventions.
  
  
  METHODS
  Outcomes were assessed four and eight months after randomization, blind to group allocation. The costs were assessed from a service use questionnaire and information provided on medication. Quality of life was assessed using the EQ-5D.
  
  
  RESULTS
  Of the 311 patients identified, 221 (71%) met the criteria for having low mood. Of these, 72 were randomly allocated to receive treatment and 79 to usual care. Over eight months follow-up there was a decrease in the combined average costs of £378 per intervention respondent and an increase in the costs of £297 per patient in the control group, which was a significant difference (p=0.03). The incremental cost-effectiveness ratio indicated that the cost per point reduction on the Beck depression inventory-II was £118.
  
  
  CONCLUSIONS
  In the short term, the adjustment group programme was cost effective when compared with usual care, for people with multiple sclerosis presenting with low mood. The longer-term costs need to be assessed.
authors.affiliation: 1Swansea Centre for Health Economics, Swansea University, Swansea, UK.
authors.forename: Ioan
authors.initials: I
authors.lastname: Humphreys
authors.forename: Avril E R
authors.initials: AE
authors.lastname: Drummond
authors.forename: Ceri
authors.initials: C
authors.lastname: Phillips
authors.forename: Nadina B
authors.initials: NB
authors.lastname: Lincoln
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology* / Q000534:rehabilitation*; D011615:Psychotherapy, Group / Q000191:economics*; D011788:Quality of Life; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Beck depression inventory; Multiple sclerosis; cost effectiveness; mood; psychological therapy; quality of life