Economic evaluation of brief psychodynamic interpersonal therapy in patients with multisomatoform disorder.
BACKGROUND
A brief psychodynamic interpersonal therapy (PIT) in patients with multisomatoform disorder has been recently shown to improve health-related quality of life.


OBJECTIVE
To assess cost-effectiveness of PIT compared to enhanced medical care in patients with multisomatoform disorder.


METHODS
An economic evaluation alongside a randomised controlled trial (International Standard Randomised Controlled Trial Number ISRCTN23215121) conducted in 6 German academic outpatient centres was performed. Incremental cost-effectiveness ratio (ICER) was calculated from the statutory health insurance perspective on the basis of quality adjusted life years (QALYs) gained at 12 months. Uncertainty surrounding the cost-effectiveness of PIT was presented by means of a cost-effectiveness acceptability curve.


RESULTS
Based on the complete-case analysis ICER was 41840 Euro per QALY. The results did not change greatly with the use of multiple imputation (ICER = 44222) and last observation carried forward (LOCF) approach to missing data (ICER = 46663). The probability of PIT being cost-effective exceeded 50% for thresholds of willingness to pay over 35 thousand Euros per QALY.


CONCLUSIONS
Cost-effectiveness of PIT is highly uncertain for thresholds of willingness to pay under 35 thousand Euros per QALY.
Department of Public Health, Faculty of Medicine, Heinrich-Heine University Duesseldorf; German Diabetes Center, Institute of Biometrics and Epidemiology, Duesseldorf, Germany.
Nadja
N
Chernyak
Department of Psychosomatic Medicine and Psychotherapy: Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
Heribert
H
Sattel
German Diabetes Center, Institute of Biometrics and Epidemiology, Duesseldorf, Germany.
Marsel
M
Scheer
German Diabetes Center, Institute of Biometrics and Epidemiology, Duesseldorf, Germany.
Christina
C
Baechle
Department of Psychosomatic Medicine, University of Düsseldorf, and Centre for Psychosomatic Medicine, Justus Liebig University of Giessen, Giessen, Germany.
Johannes
J
Kruse
Department of Psychosomatic Medicine and Psychotherapy: Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
Peter
P
Henningsen
Department of Public Health, Faculty of Medicine, Heinrich-Heine University Duesseldorf; German Diabetes Center, Institute of Biometrics and Epidemiology, Duesseldorf, Germany.
Andrea
A
Icks
D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics* / Q000379:methods; D010045:Outpatients / Q000706:statistics & numerical data*; D011614:Psychotherapy, Brief / Q000191:economics* / Q000379:methods; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D013001:Somatoform Disorders / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult