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The modeled cost‐effectiveness of family‐based and adolescent‐focused treatment for anorexia nervosa
Author(s) -
Le Long KhanhDao,
Barendregt Jan J.,
Hay Phillipa,
Sawyer Susan M.,
Hughes Elizabeth K.,
Mihalopoulos Cathrine
Publication year - 2017
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.22786
Subject(s) - anorexia nervosa , medicine , cost effectiveness , confidence interval , intervention (counseling) , population , demography , psychiatry , mental health , pediatrics , eating disorders , environmental health , risk analysis (engineering) , sociology
Abstract Background Anorexia nervosa (AN) is a prevalent, serious mental disorder. We aimed to evaluate the cost‐effectiveness of family‐based treatment (FBT) compared to adolescent‐focused individual therapy (AFT) or no intervention within the Australian healthcare system. Method A Markov model was developed to estimate the cost and disability‐adjusted life‐year (DALY) averted of FBT relative to comparators over 6 years from the health system perspective. The target population was 11–18 year olds with AN of relatively short duration. Uncertainty and sensitivity analyses were conducted to test model assumptions. Results are reported as incremental cost‐effectiveness ratios (ICER) in 2013 Australian dollars per DALY averted. Results FBT was less costly than AFT. Relative to no intervention, the mean ICER of FBT and AFT was $5,089 (95% uncertainty interval (UI): dominant to $16,659) and $51,897 ($21,591 to $1,712,491) per DALY averted. FBT and AFT are 100% and 45% likely to be cost‐effective, respectively, at a threshold of AUD$50,000 per DALY averted. Sensitivity analyses indicated that excluding hospital costs led to increases in the ICERs but the conclusion of the study did not change. Conclusion FBT is the most cost‐effective among treatment arms, whereas AFT was not cost‐effective compared to no intervention. Further research is required to verify this result.