Cost‐utility of individual internet‐based and face‐to‐face Mindfulness‐Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients

Félix Compen*, Eddy Adang, Else Bisseling, Marije van der Lee, Anne Speckens

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
It was previously determined that group‐based face‐to‐face Mindfulness‐Based Cognitive Therapy (MBCT) and individual internet‐based MBCT (eMBCT) are equally efficacious compared with treatment as usual (TAU) in reducing psychological distress. In this study, the incremental cost‐utility of both interventions compared with TAU was assessed.

Methods
This cost‐utility study included 245 self‐referred heterogeneous cancer patients with psychological distress who were randomized to MBCT, eMBCT or TAU. Healthcare costs and (informal) work‐related productivity losses were assessed by interview. Outcomes were expressed in EuroQol‐5D‐3L utility scores and quality‐adjusted life years (QALY). An economic evaluation with a time‐horizon of 3 months was conducted from the societal perspective in the intention‐to‐treat sample. In addition, secondary explorative analyses of costs and quality of life during the 9‐month follow‐up were conducted based on linear extrapolation of TAU.

Results
Paid work‐related productivity losses and societal costs were lower in both intervention conditions compared with TAU during the 3‐month intervention period. Moreover, quality of life (utility scores) improved in eMBCT versus TAU (Cohen's d: .54) and MBCT versus TAU (.53). At a willingness to pay of €20000 per QALY, the mean incremental net monetary benefit was €1916 (SD=€783) in eMBCT and €2365 (SD=€796) in MBCT versus TAU. Exploration of costs demonstrated an equal pattern of eMBCT and MBCT being superior to TAU. Quality of life at 9‐month follow‐up remained improved in both interventions.

Conclusions
Results indicate that eMBCT and MBCT are cost‐saving treatments whilst simultaneously improving quality of life for distressed cancer patients.
Original languageEnglish
Pages (from-to)294-303
JournalPsycho-Oncology
Volume29
Issue number2
DOIs
Publication statusPublished - 2020

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