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The modeled cost-effectiveness of family-based and adolescent-focused treatment for anorexia nervosa
journal contribution
posted on 2017-12-01, 00:00 authored by Long Le, J J Barendregt, P Hay, S M Sawyer, E K Hughes, Cathy MihalopoulosCathy MihalopoulosBackground: Anorexia nervosa (AN) is a prevalent, serious mental disorder. We aimed to evaluate the cost-effectiveness of family-based treatment (FBT) compared to adolescent-focused individual therapy (AFT) or no intervention within the Australian healthcare system. Method: A Markov model was developed to estimate the cost and disability-adjusted life-year (DALY) averted of FBT relative to comparators over 6 years from the health system perspective. The target population was 11–18 year olds with AN of relatively short duration. Uncertainty and sensitivity analyses were conducted to test model assumptions. Results are reported as incremental cost-effectiveness ratios (ICER) in 2013 Australian dollars per DALY averted. Results: FBT was less costly than AFT. Relative to no intervention, the mean ICER of FBT and AFT was $5,089 (95% uncertainty interval (UI): dominant to $16,659) and $51,897 ($21,591 to $1,712,491) per DALY averted. FBT and AFT are 100% and 45% likely to be cost-effective, respectively, at a threshold of AUD$50,000 per DALY averted. Sensitivity analyses indicated that excluding hospital costs led to increases in the ICERs but the conclusion of the study did not change. Conclusion: FBT is the most cost-effective among treatment arms, whereas AFT was not cost-effective compared to no intervention. Further research is required to verify this result.
History
Journal
International journal of eating disordersVolume
50Issue
12Pagination
1356 - 1366Publisher
WileyLocation
London, Eng.Publisher DOI
ISSN
0276-3478Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2017, Wiley PeriodicalsUsage metrics
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Keywords
adolescent-focused treatmentanorexia nervosaeating disorderfamily-based therapyhealth economicsSocial SciencesScience & TechnologyLife Sciences & BiomedicinePsychology, ClinicalNutrition & DieteticsPsychiatryPsychologyRANDOMIZED CONTROLLED-TRIALQUALITY-OF-LIFEEATING-DISORDERSINDIVIDUAL THERAPYGLOBAL BURDENHANDLING UNCERTAINTYPRACTICE GUIDELINESECONOMIC-EVALUATIONBULIMIA-NERVOSACLINICAL-TRIALHealth Economics
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