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Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients

Sabariego, C. ; Brach, M. ; Herschbach, P. ; Berg, P. ; Stucki, G.

In: The European Journal of Health Economics, 2011, vol. 12, no. 5, p. 489-497

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    Titre
    • Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients
    Auteur
    • Sabariego, C.. Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-University, Marchioninistraße 17, 81377, Munich, Germany
    • Brach, M.. Institute for Health and Rehabilitation Sciences, Ludwig-Maximilians-University, Marchioninistraße 17, 81377, Munich, Germany
    • Herschbach, P.. Department and Outpatient Clinic of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
    • Berg, P.. Department and Outpatient Clinic of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
    • Stucki, G.. Swiss Paraplegic Research, Postfach CH-6207, Nottwil, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • The European Journal of Health Economics, 2011, vol. 12, no. 5, p. 489-497. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:318408
    Summary
    Anxiety and fear are often associated with chronic conditions such as cancer. This paper targets the cost-effectiveness analysis of a cognitive-behavioral group therapy (CBT) in comparison to a client-centered, supportive-experiential group therapy (SET) in cancer patients with dysfunctional fear of progression. An incremental cost-effectiveness analysis was performed using data from a randomized controlled trial among cancer patients receiving inpatient rehabilitation. The means, 95% confidence intervals [95% CI], incremental cost-effectiveness graphic and acceptability curve were obtained from 1,000 bootstrap replications. A total of 174 patients were included in the economic evaluation. The estimated means [95% CI] of direct costs and reduction of fear of progression were €9,045.03 [6,359.07; 12,091.87] and 1.41 [0.93; 1.92] for patients in the SET and €6,682.78 [4,998.09; 8,440.95] and 1.44 [1.02; 1.09] for patients in the CBT. The incremental cost-effectiveness ratio [95% CI] amounts to minus €78,741.66 [−154,987.20; 110,486.32] for an additional unit of effect. Given the acceptability curve, there is a 92.4% chance that the CBT, compared with the SET, is cost-effective without the need of additional costs to payers. Our main result is the superior cost-effectiveness of the cognitive-behavioral intervention program in comparison to the non-directive encounter group for our sample of cancer patients with high levels of anxiety