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Cost‐effectiveness of CBT , SSRI , and CBT + SSRI in the treatment for panic disorder
Author(s) -
Apeldoorn F. J.,
Stant A. D.,
Hout W. J. P. J.,
Mersch P. P. A.,
den Boer J. A.
Publication year - 2014
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12169
Subject(s) - cognitive behavioral therapy , agoraphobia , panic disorder , cognitive therapy , psychiatry , randomized controlled trial , serotonin reuptake inhibitor , medicine , indirect costs , psychology , clinical psychology , cognition , anxiety , antidepressant , accounting , business
Objective The objective of this study was to assess the cost‐effectiveness of three empirically supported treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy ( CBT ), pharmacotherapy using a selective serotonin reuptake inhibitor ( SSRI ), or the combination of both ( CBT + SSRI ). Method Cost‐effectiveness was examined based on the data from a multicenter randomized controlled trial. The H amilton A nxiety R ating S cale was selected as a primary health outcome measure. Data on costs from a societal perspective (i.e., direct medical, direct non‐medical, and indirect non‐medical costs) were collected in the study sample ( N = 150) throughout a 24‐month period in which patients received active treatment during the first twelve months and were seen twice for follow‐up in the next twelve months. Results Total costs were largely influenced by costs of the interventions and productivity losses. The mean total societal costs were lower for CBT as compared to SSRI and CBT + SSRI . Costs of medication use were substantial for both SSRI and CBT + SSRI . When examining the balance between costs and health outcomes, both CBT and CBT + SSRI led to more positive outcomes than SSRI . Conclusion Cognitive behavioral therapy is associated with the lowest societal costs. Cognitive behavioral therapy and CBT + SSRI are more cost‐effective treatments for panic disorder with or without agoraphobia as compared to SSRI only.