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A cost effectiveness analysis of stepped care treatment for bulimia nervosa
Author(s) -
Crow Scott J.,
Agras W. Stewart,
Halmi. Katherine A.,
Fairburn Christopher G.,
Mitchell James E.,
Nyman John A.
Publication year - 2013
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.22087
Subject(s) - bulimia nervosa , quality of life (healthcare) , cognition , randomized controlled trial , cost effectiveness , cognitive therapy , cognitive behavioral therapy , psychology , psychiatry , medicine , clinical psychology , eating disorders , psychotherapist , risk analysis (engineering) , surgery
Background: The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown. Aims: To examine the cost effectiveness of stepped care treatment for BN. Method: Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety‐three women who met DSM‐IV criteria for BN received stepped care treatment or cognitive behavioral therapy. Cost effectiveness ratios were compared. Results: The cost per abstinent subject was $12,146 for stepped care, and $20,317 for cognitive behavioral therapy. Quality of life ratings improved significantly with treatment, and family/significant other time burden diminished substantially. Discussion: In this trial, stepped care for BN appeared cost effective in comparison to cognitive behavioral therapy. Treatment was associated with improved quality of life and diminished time costs of illness. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013)