Cost-utility of a specific collaborative group intervention for patients with functional somatic syndromes

• Published in: Journal of psychosomatic research 2016-11, Vol.90, p.43-50
• Main Authors: Konnopka, Alexander, Dr, König, Hans-Helmut, Prof, Kaufmann, Claudia, Dr, Egger, Nina, Dr, Wild, Beate, Prof, Szecsenyi, Joachim, Prof, Herzog, Wolfgang, Prof, Schellberg, Dieter, Dipl.-Psych, Schaefert, Rainer, PD
• Format: Article
• Language: English
• Subjects: Adult; Collaborative care; Cooperative Behavior; Cost-Benefit Analysis - methods; Cost-effectiveness; Early Medical Intervention - economics; Early Medical Intervention - methods; Female; Functional somatic syndromes; General Practitioners - economics; Health Care Costs; Humans; Male; Medically Unexplained Symptoms; Middle Aged; Psychiatry; Quality of Life - psychology; Quality-Adjusted Life Years; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2016.09.001

Abstract Background Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. Objective To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. Methods An economic evaluation alongside a cluster-randomised controlled trial was performed. 35 general practitioners (GPs) recruited 300 FSS patients. Patients in the CGI arm were offered 10 group sessions within 3 months and 2 booster sessions 6 and 12 months after baseline. Costs were assessed via questionnaire. Quality adjusted life years (QALYs) were calculated using the SF-6D index, derived from the 36-item short-form health survey (SF-36). We calculated patients ' net-monetary-benefit (NMB), estimated the treatment effect via regression, and generated cost-effectiveness acceptability curves. Results Using intention-to-treat analysis, total costs during the 12-month study period were 5 777EUR in the intervention, and 6 858EUR in the control group. Controlling for possible confounders, we found a small, but significant positive intervention effect on QALYs (+ 0.017; p = 0.019) and an insignificant cost saving resulting from a cost-increase in the control group ( − 10.5%; p = 0.278). NMB regression showed that the probability of CGI to be cost-effective was 69% for a willingness to pay (WTP) of 0EUR/QALY, increased to 92% for a WTP of 50,000EUR/QALY and reached the level of 95% at a WTP of 70,375EUR/QALY. Subgroup analyses yielded that CGI was only cost-effective in severe somatic symptom severity (PHQ-15 ≥ 15). Conclusion CGI has a high probability to be a cost-effective treatment for FSS, in particular for patients with severe somatic symptom severity.