Trial-based economic evaluation of mindfulness-based cognitive therapy compared to treatment as usual for bipolar disorder.
Ben Wijnen, Maud Jansen, Annelieke Van Velthoven, Imke Hanssen, Marloes Huijbers, Silvia Evers, Anne Speckens
International journal of methods in psychiatric research September 12, 2023 DOI: 10.1002/mpr.1981 via PubMed
Summary
Adding mindfulness-based cognitive therapy (MBCT) to treatment as usual (TAU) for adults with bipolar disorder is likely cost-effective compared to TAU alone. Over 15 months, total societal costs were €615 lower for the MBCT-plus-TAU group, and healthcare costs differed significantly between groups. A small gain in quality-adjusted life years (QALYs) combined with lower costs (€836 after adjustment) made MBCT-plus-TAU the dominant strategy. The probability that the combination was cost-effective was 65%. Sensitivity analyses confirmed the robustness of these results. The difference in clinical effect was small or negligible, but the intervention still reduced overall costs.
Study at a glance
| Characteristics | Economic evaluation Peer reviewed |
|---|---|
| Sample size | 144 |
| Population | Adults with bipolar disorder |
| Topics | Meditation |
| Keywords | Bipolar disorder Cost-benefit analysis Quality-adjusted life years |
| Citations | 2 |
| Key finding | Adding MBCT to treatment as usual for bipolar disorder appears cost-effective, with lower costs and a small gain in QALYs compared to treatment as usual alone. |
Abstract
Aim of this study was to assess the cost-effectiveness and cost-utility of mindfulness-based cognitive therapy (MBCT) and treatment as usual (TAU) compared to TAU alone in adults with Bipolar disorder (BD). An economic evaluation with a time horizon of 15 months was conducted from a societal perspective. Outcomes were expressed in costs per quality adjusted life years (QALYs) and costs per responder using the inventory of depressive symptomatology clinician rating score. People with BD (N = 144) were included in this study. From a societal perspective, the difference of total costs between MBCT + TAU and TAU was €615, with lower costs in the MBCT + TAU group. Only healthcare costs differed significantly between the two groups. A small difference in QALYs in favor of MBCT + TAU was found combined with lower costs (-€836; baseline adjusted) for MBCT + TAU compared to TAU, resulting in a dominant incremental cost-utility ratio. The probability that the MBCT + TAU was cost-effective was 65%. All sensitivity analyses attested to the robustness of the base case analyses. Concludingly, MBCT + TAU seems to be cost-effective compared to TAU alone, indicated by a small or neglectable difference in effect, in favor of MBCT + TAU, while resulting in lower costs.