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Psychooncology. 2018 Jul;27(7):1772-1779. doi: 10.1002/pon.4726. Epub 2018 Apr 27.

Cost-utility analysis of meaning-centered group psychotherapy for cancer survivors.

Author information

1
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
2
IDC Center for Psychological Care for Cancer Patients, OLVG Hospital, Amsterdam, The Netherlands.
3
Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands.
4
Department of Psychology, University of Roehampton, London, UK.
5
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
6
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
7
VU University Medical Center, Epidemiology & Biostatistics, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

Meaning-centered group psychotherapy for cancer survivors (MCGP-CS) improves meaning, psychological well-being, and mental adjustment to cancer and reduces psychological distress. This randomized controlled trial was conducted to investigate the cost-utility of MCGP-CS compared with supportive group psychotherapy (SGP) and care-as-usual (CAU).

METHODS:

In total, 170 patients were randomized to MCGP-CS, SGP, or CAU. Intervention costs, direct medical and nonmedical costs, productivity losses, and health-related quality of life were measured until 6 months follow-up, using the TIC-P, PRODISQ, data from the hospital information system, and the EQ-5D. The cost-utility was calculated by comparing mean cumulative costs and quality-adjusted life years (QALYs).

RESULTS:

Mean total costs ranged from €4492 (MCGP-CS) to €5304 (CAU). Mean QALYs ranged .507 (CAU) to .540 (MCGP-CS). MCGP-CS had a probability of 74% to be both less costly and more effective than CAU, and 49% compared with SGP. Sensitivity analyses showed these findings are robust. If society is willing to pay €0 for one gained QALY, MCGP-CS has a 78% probability of being cost-effective compared with CAU. This increases to 85% and 92% at willingness-to-pay thresholds of €10 000 and €30 000, which are commonly accepted thresholds.

CONCLUSIONS:

MCGP-CS is highly likely a cost-effective intervention, meaning that there is a positive balance between the costs and gains of MCGP-CS, in comparison with SGP and CAU.

KEYWORDS:

MCGP; cancer; cost-effectiveness; cost-utility analysis; existential; group psychotherapy; meaning; meaning-centered psychotherapy; oncology; psychotherapy

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