Economic evaluation of mindfulness group therapy for patients with depression, anxiety, stress and adjustment disorders compared with treatment as usual.

Author: Saha S1, Jarl J2, Gerdtham UG3, Sundquist K4, Sundquist J4
Affiliation:
1Postdoctoral Researcher,Health Economics Unit,Department of Clinical Sciences (Malmö),Lund University,Sweden.
2Associate Professor,Health Economics Unit,Department of Clinical Sciences (Malmö),Lund University,Sweden.
3Professor,Health Economics Unit,Department of Clinical Sciences (Malmö),Department of Economics,Centre for Economic Demography and Center for Primary Health Care Research,Lund University,Sweden.
4Professor,Center for Primary Health Care Research,Lund University,Sweden;Department of Family Medicine and Community Health,Icahn School of Medicine at Mount Sinai,USA; andCenter for Community-based Healthcare Research and Education,Shimane University,Japan.
Conference/Journal: Br J Psychiatry.
Date published: 2018 Nov 23
Other: Volume ID: 1-7 , Special Notes: doi: 10.1192/bjp.2018.247. [Epub ahead of print] , Word Count: 248


BACKGROUND: A randomised controlled trial found that a structured mindfulness group therapy (MGT) programme was as effective as treatment as usual (mostly cognitive-behavioural therapy) for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden (ClinicalTrials.gov: NCT01476371).AimsTo perform a cost-effectiveness analysis of MGT compared with treatment as usual from both a healthcare and a societal perspective for the trial duration (8 weeks).

METHOD: The costs from a healthcare perspective included treatment as usual, medication and costs for providing MGT. The societal perspective included costs from the healthcare perspective plus savings from productivity gains for the trial duration. The effectiveness was measured as quality-adjusted life-years (QALY) using the EQ-5D-5L questionnaire and the UK value set. Uncertainty surrounding the incremental costs and effects were estimated using non-parametric bootstrapping with 5000 replications and presented with 95% confidence intervals and cost-effectiveness acceptability curves.

RESULTS: The MGT group had significantly lower healthcare and societal costs (mean differences -€115 (95% CI -193 to -36) and -€112 (95% CI -207 to -17), respectively) compared with the control group. In terms of effectiveness, there was no significant difference in QALY gain (mean difference -0.003, 95% CI -0.0076 to 0.0012) between the two groups.

CONCLUSIONS: MGT is a cost-saving alternative to treatment as usual over the trial duration from both a healthcare and a societal perspective for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden.Declaration of interestNone.

KEYWORDS: Economic evaluation; cognitive behavioural therapy; mindfulness group therapy

PMID: 30468136 DOI: 10.1192/bjp.2018.247

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