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A cost effectiveness analysis of stepped care treatment for bulimia nervosa
Scott J Crow1, W Stewart Agras, Katherine A Halmi
1Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, Minnesota 55454-1495, USA. crowx002@umn.edu
Background:
The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown.
Aims:
To examine the cost effectiveness of stepped care treatment for BN.
Method:
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.
Discussion:
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.
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