Cost-utility of a specific collaborative group intervention for patients with functional somatic syndromes |
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Institution: | 1. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany;2. Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany;3. Department of General Practice and Health Services Research, University Hospital Heidelberg, Germany;1. Department of Psychological Medicine, King''s College London, London, UK;2. Department of Psychiatry, Psychotherapy and Psychotraumatology, Bundeswehr Hospital, Berlin, Germany;3. Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, Munich, Germany |
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Abstract: | BackgroundCollaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life.ObjectiveTo analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS.MethodsAn economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3 months and 2 booster sessions 6 and 12 months after baseline. Costs were assessed via questionnaire. Quality adjusted life years (QALYs) were calculated using the SF-6D index, derived from the 36-item short-form health survey (SF-36). We calculated patients' net-monetary-benefit (NMB), estimated the treatment effect via regression, and generated cost-effectiveness acceptability curves.ResultsUsing intention-to-treat analysis, total costs during the 12-month study period were 5777EUR in the intervention, and 6858EUR in the control group. Controlling for possible confounders, we found a small, but significant positive intervention effect on QALYs (+ 0.017; p = 0.019) and an insignificant cost saving resulting from a cost-increase in the control group (? 10.5%; p = 0.278). NMB regression showed that the probability of CGI to be cost-effective was 69% for a willingness to pay (WTP) of 0EUR/QALY, increased to 92% for a WTP of 50,000EUR/QALY and reached the level of 95% at a WTP of 70,375EUR/QALY. Subgroup analyses yielded that CGI was only cost-effective in severe somatic symptom severity (PHQ-15 ≥ 15).ConclusionCGI has a high probability to be a cost-effective treatment for FSS, in particular for patients with severe somatic symptom severity. |
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