Economic evaluation of web‐based guided self‐help cognitive behavioral therapy‐enhanced for binge‐eating disorder compared to a waiting list: A randomized controlled trial
International Journal of Eating Disorders, vol. 56, pp. 1772–1784
Abstract
INTRODUCTION: The aim is to perform an economic evaluation alongside a randomized controlled trial comparing guided self-help cognitive behavioral therapy-enhanced (CBT-E) for binge-eating disorder (BED) to a waiting list control condition. METHODS: BED patients (N = 212) were randomly assigned to guided self-help CBT-E or the 3-month waiting list. Measurements took place at baseline and the end-of-treatment. The cost-effectiveness analysis was performed using the number of binge-eating episodes during the last 28 days as an outcome indicator according to the eating disorder examination. A cost-utility analysis was performed using the EuroQol-5D. RESULTS: The difference in societal costs over the 3 months of the intervention between both conditions was €679 (confidence interval [CI] 50-1330). The incremental costs associated with one incremental binge eating episode prevented in the guided self-help condition was approximately €18 (CI 1-41). From a societal perspective there was a 96% likelihood that guided self-help CBT-E led to a greater number of binge-eating episodes prevented, but at higher costs. Each additional quality-adjusted life year (QALY) gained was associated with incremental costs of €34,000 (CI 2494-154,530). With a 95% likelihood guided self-help CBT-E led to greater QALY gain at higher costs compared to waiting for treatment. Based on the National Institute for Health and Clinical Excellence willingness-to-pay threshold of €35,000 per QALY, guided self-help CBT-E can be considered cost-effective with a likelihood of 95% from a societal perspective. DISCUSSION: Guided self-help CBT-E is likely a cost-effective treatment for BED in the short-term (3-month course of treatment). Comparison to treatment-as-usual is recommended for future research, as it enables an economic evaluation with a longer time horizon. PUBLIC SIGNIFICANCE: Offering treatment remotely has several benefits for patients suffering from binge-eating disorders. Guided self-help CBT-E is an efficacious and likely cost-effective treatment, reducing binge eating and improving quality-of-life, albeit at higher societal costs.
Authors 8
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Bernou Melisse corresponding Aachen Section Clinical Psychology Leiden University Leiden The Netherlands Section Clinical Psychology
Affiliation as printed
Novarum Center for Eating Disorders & Obesity Amstelveen The Netherlands
Section Clinical Psychology Leiden University Leiden The Netherlands
Novarum Center for Eating Disorders & Obesity Amstelveen The Netherlands
Section Clinical Psychology, Leiden University, Leiden, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Trimbos Institute · Arkin · Amsterdam University Medical Centers · University of Amsterdam
Affiliation as printed
Department of Psychiatry Amsterdam UMC, Location AMC, University of Amsterdam Amsterdam The Netherlands
Research Department Arkin Mental Health Institute Amsterdam The Netherlands
Trimbos Institute, Netherlands Institute of Mental Health and Addiction Utrecht The Netherlands
Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
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Affiliation as printed
Novarum Center for Eating Disorders & Obesity Amstelveen The Netherlands
Novarum Center for Eating Disorders & Obesity Amstelveen The Netherlands
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Affiliation as printed
Novarum Center for Eating Disorders & Obesity Amstelveen The Netherlands
Novarum Center for Eating Disorders & Obesity Amstelveen The Netherlands
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Affiliation as printed
Research Department Arkin Mental Health Institute Amsterdam The Netherlands
Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
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Eric F. van Furth Aachen Department of Psychiatry Leiden University Medical Center Leiden The Netherlands Department of Psychiatry, Leiden University Medical Center GGZ Rivierduinen Eating Disorders Ursula
Leiden University Medical Center · GGZ Rivierduinen
Affiliation as printed
Department of Psychiatry Leiden University Medical Center Leiden The Netherlands
GGZ Rivierduinen Eating Disorders Ursula Leiden The Netherlands
Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands
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Affiliation as printed
Research Department Arkin Mental Health Institute Amsterdam The Netherlands
Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
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Edwin de Beurs Aachen Section Clinical Psychology Leiden University Leiden The Netherlands Section Clinical Psychology
Affiliation as printed
Research Department Arkin Mental Health Institute Amsterdam The Netherlands
Section Clinical Psychology Leiden University Leiden The Netherlands
Research Department, Arkin Mental Health Institute, Amsterdam, The Netherlands
Section Clinical Psychology, Leiden University, Leiden, The Netherlands
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