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Computer-aided self-exposure therapy for phobia/panic disorder: a pilot economic evaluation
Paul McCrone1, Isaac M Marks, David Mataix-Cols
1Centre for the Economics of Mental Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, UK. p.mccrone@iop.kcl.ac.uk
Cognitive Behaviour Therapy
|March 24, 2009
Summary
Computer-guided exposure therapy like FearFighter (FF) is cost-effective for phobias. FF and clinician-led exposure improved outcomes more than relaxation but at a higher cost.
Area of Science:
- Psychiatry
- Health Economics
- Behavioral Therapy
Background:
- Phobia and panic disorders are prevalent mental health conditions.
- Exposure therapy is an effective treatment, with computer-guided systems showing promise.
- Demonstrating cost-effectiveness is crucial for widespread adoption of such interventions.
Purpose of the Study:
- To compare the cost-effectiveness of the computer-guided self-help system FearFighter (FF) against computed-aided relaxation and clinician-led exposure therapy.
- To evaluate treatment efficacy using patient self-ratings of primary problems and global phobia severity.
Main Methods:
- Economic analysis based on data from a randomized controlled trial of FF.
- Calculation of clinician costs including therapist hours and FF system expenses.
- Determination of incremental cost-effectiveness ratios (ICERs) and generation of cost-effectiveness acceptability curves (CEACs).
Main Results:
- Both FF and clinician-led exposure were more effective than relaxation but incurred higher costs.
- FF demonstrated a lower cost per unit of improvement on the main problem scale (64 UK pounds) compared to clinician-led exposure (100 UK pounds) versus relaxation.
- FF showed greater cost-effectiveness using the global phobia rating (112 UK pounds) than clinician-led exposure (128 UK pounds).
Conclusions:
- Computer-guided exposure therapy, exemplified by FF, presents a cost-effective treatment option for phobias.
- The cost-effectiveness of FF could potentially be improved with less highly trained support staff.
- Findings suggest FF is a viable and economically sound alternative to traditional therapies, though secondary analysis necessitates cautious interpretation.
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