Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: a cost-effectiveness study

Area of Science:

• Health Economics
• Psychiatry
• Clinical Psychology

Background:

• Persistent medically unexplained symptoms (MUS) pose a significant challenge in healthcare.
• Mindfulness-Based Cognitive Therapy (MBCT) is a potential intervention for managing MUS.
• Enhanced Usual Care (EUC) serves as a comparator for evaluating MBCT's effectiveness and cost.

Purpose of the Study:

• To assess the cost-effectiveness of MBCT compared to EUC for patients with persistent MUS.
• To analyze healthcare resource utilization and quality of life outcomes.
• To determine the incremental cost-effectiveness ratio (ICER) and probability of cost-effectiveness.

Main Methods:

• A full economic evaluation was conducted over a one-year time horizon from a societal perspective.
• Cost data were collected using prospective cost diaries.
• Health-related Quality of Life was measured using the SF-6D, with outcomes analyzed per Quality-Adjusted Life Year (QALY).
• Bootstrap simulations were used to calculate mean costs, QALYs, and ICERs.

Main Results:

• MBCT participants incurred higher mental health costs but lower hospital costs than EUC participants.
• The mean bootstrapped cost per QALY gained for MBCT was €56,637.
• At a willingness to pay of €80,000 per QALY, MBCT had a 57% probability of being cost-effective.
• Total costs did not differ significantly between MBCT and EUC.

Conclusions:

• MBCT may lead to a shift in healthcare resource utilization, with increased mental health care costs and decreased hospital costs.
• The cost-effectiveness of MBCT might be underestimated due to higher dropout rates in the EUC group.
• MBCT could offer more effective care for persistent MUS, but long-term impacts require further investigation.