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Economic evaluation of brief psychodynamic interpersonal therapy in patients with multisomatoform disorder
Nadja Chernyak1, Heribert Sattel2, Marsel Scheer3
1Department of Public Health, Faculty of Medicine, Heinrich-Heine University Duesseldorf; German Diabetes Center, Institute of Biometrics and Epidemiology, Duesseldorf, Germany.
Background:
A brief psychodynamic interpersonal therapy (PIT) in patients with multisomatoform disorder has been recently shown to improve health-related quality of life.
Aims:
To assess cost-effectiveness of PIT compared to enhanced medical care in patients with multisomatoform disorder.
Method:
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.
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