Incremental cost-effectiveness of a collaborative care intervention for panic disorder.

Area of Science:

• Psychiatry
• Health Economics
• Primary Care Medicine

Background:

• Panic disorder is a common and debilitating condition often treated in primary care settings.
• Significant disparities exist in the quality of panic disorder treatment provided within primary care.
• This study evaluates the cost-effectiveness of an integrated intervention for panic disorder in primary care.

Purpose of the Study:

• To determine the incremental cost-effectiveness of a combined cognitive behavioral therapy (CBT) and pharmacotherapy intervention for panic disorder.
• To compare this intervention against usual primary care treatment.
• To assess outcomes in terms of anxiety-free days (AFDs) and quality-adjusted life-years (QALYs).

Main Methods:

• A randomized controlled trial involving 232 primary care patients diagnosed with panic disorder.
• Participants were assigned to either usual care or a combined CBT and pharmacotherapy intervention delivered by a mental health therapist.
• Outcomes measured included outpatient costs, AFDs, and QALYs over a 12-month period.

Main Results:

• Intervention patients achieved an average of 60.4 additional anxiety-free days compared to usual care.
• The incremental cost per additional anxiety-free day was $8.40.
• The cost per QALY ranged from $14,158 to $24,776, comparable to established medical interventions.

Conclusions:

• The combined CBT and pharmacotherapy intervention demonstrated substantial clinical benefits for panic disorder patients.
• This integrated approach led to a moderate increase in ambulatory care costs.
• The findings support the cost-effectiveness of this intervention within primary care settings.