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J Psychosom Res. 2016 Nov;90:43-50. doi: 10.1016/j.jpsychores.2016.09.001. Epub 2016 Sep 2.

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

Author information

1
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: a.konnopka@uke.de.
2
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: h.koenig@uke.de.
3
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany. Electronic address: claudia.kaufmann@med.uni-heidelberg.de.
4
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: n.egger@uke.de.
5
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany. Electronic address: Beate.wild@med.uni-heidelberg.de.
6
Department of General Practice and Health Services Research, University Hospital Heidelberg, Germany. Electronic address: joachim.szecsenyi@med.uni-heidelberg.de.
7
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany. Electronic address: wolfgang.herzog@med.uni-heidelberg.de.
8
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany. Electronic address: dieter.schellberg@med.uni-heidelberg.de.
9
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Germany. Electronic address: Rainer.Schaefert@med.uni-heidelberg.de.

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 3months and 2 booster sessions 6 and 12months 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 5777EUR in the intervention, and 6858EUR 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.

KEYWORDS:

Collaborative care; Cost-effectiveness; Functional somatic syndromes

[Indexed for MEDLINE]

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