• Media type: E-Article
  • Title: The cost‐effectiveness of cognitive behavioral therapy for bulimia nervosa in the Australian context
  • Contributor: Le, Long Khanh‐Dao; Hay, Phillipa; Wade, Tracey; Touyz, Stephen; Mihalopoulos, Cathrine
  • Published: Wiley, 2017
  • Published in: International Journal of Eating Disorders, 50 (2017) 12, Seite 1367-1377
  • Language: English
  • DOI: 10.1002/eat.22790
  • ISSN: 0276-3478; 1098-108X
  • Origination:
  • Footnote:
  • Description: AbstractObjectiveThis study was to model the cost‐effectiveness of specialist‐delivered cognitive behavioral therapy for bulimia nervosa (CBT‐BN) compared to no intervention within the Australian context.MethodAn illness‐death model was developed to estimate the cost per disability‐adjusted life‐year (DALY) averted of CBT‐BN over 2 years from the healthcare perspective. Target population was adults aged 18–65 years with BN. Results are reported as incremental cost‐effectiveness ratios (ICER) in 2013 Australian dollars per DALY averted. Uncertainty and sensitivity analyses were conducted to test the robustness of results.ResultsPrimary analysis indicated that CBT‐BN was associated with greater DALY averted (0.10 DALY per person) and higher costs ($1,435 per person) than no intervention, resulting the mean ICER of $14,451 per DALY averted (95% uncertainty interval [UI]: $8,762 to $35,650). Uncertainty analysis indicated CBT‐BN is 99% likely to be cost‐effective at a threshold of $50,000 per DALY averted. Including the patients' time and travel costs resulted in the mean ICER of $18,858 per DALY averted (95% UI: $11,235 to $46,026). Sensitivity analysis indicated the intervention was not cost‐effective if over 80% people discontinued treatment. Other analyses including a reduced time horizon, increased remission rates, and 4‐month effect size of CBT‐BN increases the ICERs but these ICERs remained well below under a threshold of $50,000 per DALY averted.ConclusionThis study has demonstrated that CBT‐BN for adults with BN is a cost‐effective treatment intervention. Further research is required to investigate the practicability of CBT‐ED and the cost‐effectiveness of other formats of CBT‐BN delivery.