Cost utility analysis of a collaborative stepped care intervention for panic and generalized anxiety disorders in primary care

M. Goorden, A.D.T. Muntingh, H.W.J. van Marwijk, P. Spinhoven, H.J. Adèr, A.J. van Balkom, C.M. van der Feltz-Cornelis, L. Hakkaart-van Roijen

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25 Citations (Scopus)

Abstract

Objective
Generalized anxiety and panic disorders are a burden on the society because they are costly and have a significant adverse effect on quality of life. The aim of this study was to evaluate the cost-utility of a collaborative stepped care intervention for panic disorder and generalized anxiety disorder in primary care compared to care as usual from a societal perspective.
Methods
The design of the study was a two armed cluster randomized controlled trial. In total 43 primary care practices in the Netherlands participated in the study. Eventually, 180 patients were included (114 collaborative stepped care, 66 care as usual). Baseline measures and follow-up measures (3, 6, 9 and 12 months) were assessed using questionnaires. We applied the TiC-P, the SF-HQL and the EQ-5D respectively measuring health care utilization, production losses and health related quality of life.
Results
The average annual direct medical costs in the collaborative stepped care group were 1854 Euro (95% C.I., 1726 to 1986) compared to €1503 (95% C.I., 1374 to 1664) in the care as usual group. The average quality of life years (QALYs) gained was 0.05 higher in the collaborative stepped care group, leading to an incremental cost effectiveness ratio (ICER) of 6965 Euro per QALY. Inclusion of the productivity costs, consequently reflecting the full societal costs, decreased the ratio even more.
Conclusion
The study showed that collaborative stepped care was a cost effective intervention for panic disorder and generalized anxiety disorder and was even dominant when a societal perspective was taken.
Keywords: Anxiety, Cost utility, Panic, Randomized trial, Societal perspective, Stepped care
Original languageEnglish
Pages (from-to)57-63
JournalJournal of Psychosomatic Research
Volume77
Issue number1
DOIs
Publication statusPublished - 2014

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