Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder.
To assess from a health sector perspective the incremental cost-effectiveness of interventions for generalized anxiety disorder (cognitive behavioural therapy [CBT] and serotonin and noradrenaline reuptake inhibitors [SNRIs]) and panic disorder (CBT, selective serotonin reuptake inhibitors [SSRIs] a...
| Publicado en: | Australian & New Zealand Journal of Psychiatry Vol. 38; no. 8; pp. 602 - 613 |
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| Autores principales: | , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Sage Publications Inc.
Aug2004
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106082473&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106082473 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Aug2004 vid: 38 iid: 8 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 106082473 106082473 2009398109 10.1080/j.1440-1614.2004.01423.x NLM15298582 106082473 ppf: 602 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder. aug: au: Heuzenroeder L Donnelly M Haby MM Mihalopoulos C Rossell R Carter R Andrews G Vos T sug: subj: Alcohols Economics Antidepressive Agents, Tricyclic Economics Anxiety Disorders Economics Anxiety Disorders Therapy Imipramine Economics Mental Health Services Economics Panic Disorder Economics Panic Disorder Therapy Paroxetine Economics Psychotherapy Economics Serotonin Uptake Inhibitors Economics Alcohols Therapeutic Use Antidepressive Agents, Tricyclic Therapeutic Use Anxiety Disorders Drug Therapy Australia Cost Benefit Analysis Disability Evaluation Imipramine Therapeutic Use Panic Disorder Drug Therapy Paroxetine Therapeutic Use Serotonin Uptake Inhibitors Therapeutic Use Time Factors Human ab: To assess from a health sector perspective the incremental cost-effectiveness of interventions for generalized anxiety disorder (cognitive behavioural therapy [CBT] and serotonin and noradrenaline reuptake inhibitors [SNRIs]) and panic disorder (CBT, selective serotonin reuptake inhibitors [SSRIs] and tricyclic antidepressants [TCAs]). The health benefit is measured as a reduction in disability-adjusted life years (DALYs), based on effect size calculations from meta-analyses of randomised controlled trials. An assessment on second stage filters ('equity', 'strength of evidence', 'feasibility' and 'acceptability to stakeholders') is also undertaken to incorporate additional factors that impact on resource allocation decisions. Costs and benefits are calculated for a period of one year for the eligible population (prevalent cases of generalized anxiety disorder/panic disorder identified in the National Survey of Mental Health and Wellbeing, extrapolated to the Australian population in the year 2000 for those aged 18 years and older). Simulation modelling techniques are used to present 95% uncertainty intervals (UI) around the incremental cost-effectiveness ratios (ICERs). Compared to current practice, CBT by a psychologist on a public salary is the most cost-effective intervention for both generalized anxiety disorder (A$6900/DALY saved; 95% UI A$4000 to A$12 000) and panic disorder (A$6800/DALY saved; 95% UI A$2900 to A$15 000). Cognitive behavioural therapy results in a greater total health benefit than the drug interventions for both anxiety disorders, although equity and feasibility concerns for CBT interventions are also greater. Cognitive behavioural therapy is the most effective and cost-effective intervention for generalized anxiety disorder and panic disorder. However, its implementation would require policy change to enable more widespread access to a sufficient number of trained therapists for the treatment of anxiety disorders. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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