TY - JOUR
T1 - Cost-effectiveness of twice-weekly versus once-weekly sessions of cognitive-behavioural therapy and interpersonal psychotherapy for depression at 12 months after start of treatment
T2 - randomised controlled trial
AU - Bosmans, Judith E.
AU - Bruijniks, Sanne J. E.
AU - el Alili, Mohamed
AU - Hollon, Steven D.
AU - Peeters, Frenk P. M. L.
AU - Arntz, Arnoud
AU - Cuijpers, Pim
AU - Lemmens, Lotte H. J. M.
AU - Dingemanse, Pieter
AU - Willems, Linda
AU - van Oppen, Patricia
AU - van den Boogaard, Michael
AU - Spijker, Jan
AU - Twisk, Jos W. R.
AU - Huibers, Marcus J. H.
N1 - Funding Information: This study was funded by ZonMw and Stichting tot Steun Vereniging tot Christelijke Verzorging. The funders were not involved in the study design; the collection, analysis and interpretation of data; the writing of the report or the decision to submit the article for publication. Publisher Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
PY - 2023/10/13
Y1 - 2023/10/13
N2 - Background Cost-effective treatments are needed to reduce the burden of depression. One way to improve the cost-effectiveness of psychotherapy might be to increase session frequency, but keep the total number of sessions constant. Aim To evaluate the cost-effectiveness of twice-weekly compared with once-weekly psychotherapy sessions after 12 months, from a societal perspective. Method An economic evaluation was conducted alongside a randomised controlled trial comparing twice-weekly versus once-weekly sessions of psychotherapy (cognitive-behavioural therapy or interpersonal psychotherapy) for depression. Missing data were handled by multiple imputation. Statistical uncertainty was estimated with bootstrapping and presented with cost-effectiveness acceptability curves. Results Differences between the two groups in depressive symptoms, physical and social functioning, and quality-adjusted life-years (QALY) at 12-month follow-up were small and not statistically significant. Total societal costs in the twice-weekly session group were higher, albeit not statistically significantly so, than in the once-weekly session group (mean difference €2065, 95% CI -686 to 5146). The probability that twice-weekly sessions are cost-effective compared with once-weekly sessions was 0.40 at a ceiling ratio of €1000 per point improvement in Beck Depression Inventory-II score, 0.32 at a ceiling ratio of €50 000 per QALY gained, 0.23 at a ceiling ratio of €1000 per point improvement in physical functioning score and 0.62 at a ceiling ratio of €1000 per point improvement in social functioning score. Conclusions Based on the current results, twice-weekly sessions of psychotherapy for depression are not cost-effective over the long term compared with once-weekly sessions.
AB - Background Cost-effective treatments are needed to reduce the burden of depression. One way to improve the cost-effectiveness of psychotherapy might be to increase session frequency, but keep the total number of sessions constant. Aim To evaluate the cost-effectiveness of twice-weekly compared with once-weekly psychotherapy sessions after 12 months, from a societal perspective. Method An economic evaluation was conducted alongside a randomised controlled trial comparing twice-weekly versus once-weekly sessions of psychotherapy (cognitive-behavioural therapy or interpersonal psychotherapy) for depression. Missing data were handled by multiple imputation. Statistical uncertainty was estimated with bootstrapping and presented with cost-effectiveness acceptability curves. Results Differences between the two groups in depressive symptoms, physical and social functioning, and quality-adjusted life-years (QALY) at 12-month follow-up were small and not statistically significant. Total societal costs in the twice-weekly session group were higher, albeit not statistically significantly so, than in the once-weekly session group (mean difference €2065, 95% CI -686 to 5146). The probability that twice-weekly sessions are cost-effective compared with once-weekly sessions was 0.40 at a ceiling ratio of €1000 per point improvement in Beck Depression Inventory-II score, 0.32 at a ceiling ratio of €50 000 per QALY gained, 0.23 at a ceiling ratio of €1000 per point improvement in physical functioning score and 0.62 at a ceiling ratio of €1000 per point improvement in social functioning score. Conclusions Based on the current results, twice-weekly sessions of psychotherapy for depression are not cost-effective over the long term compared with once-weekly sessions.
KW - Depressive disorders
KW - cost-effectiveness
KW - individual psychotherapy
KW - out-patient treatment
KW - randomised controlled trial
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U2 - https://doi.org/10.1192/bjo.2023.548
DO - https://doi.org/10.1192/bjo.2023.548
M3 - Article
C2 - 37830493
SN - 2056-4724
VL - 9
JO - BJPsych Open
JF - BJPsych Open
IS - 6
M1 - e186
ER -