Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder
Version of Record online: 3 JUL 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Psychiatrica Scandinavica
Volume 129, Issue 4, pages 286–295, April 2014
How to Cite
Cost-effectiveness of CBT, SSRI, and CBT+SSRI in the treatment for panic disorder., , , , .
- Issue online: 13 MAR 2014
- Version of Record online: 3 JUL 2013
- Manuscript Accepted: 27 MAY 2013
- Dutch Health Insurance Board. Grant Number: OG00-029
- cost-effectiveness analysis;
- economic evaluation;
- panic disorder;
- randomized controlled trial;
- cognitive behavioral therapy;
- drug treatment
The objective of this study was to assess the cost-effectiveness of three empirically supported treatments for panic disorder with or without agoraphobia: cognitive behavioral therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI), or the combination of both (CBT+SSRI).
Cost-effectiveness was examined based on the data from a multicenter randomized controlled trial. The Hamilton Anxiety Rating Scale was selected as a primary health outcome measure. Data on costs from a societal perspective (i.e., direct medical, direct non-medical, and indirect non-medical costs) were collected in the study sample (N = 150) throughout a 24-month period in which patients received active treatment during the first twelve months and were seen twice for follow-up in the next twelve months.
Total costs were largely influenced by costs of the interventions and productivity losses. The mean total societal costs were lower for CBT as compared to SSRI and CBT+SSRI. Costs of medication use were substantial for both SSRI and CBT+SSRI. When examining the balance between costs and health outcomes, both CBT and CBT+SSRI led to more positive outcomes than SSRI.
Cognitive behavioral therapy is associated with the lowest societal costs. Cognitive behavioral therapy and CBT+SSRI are more cost-effective treatments for panic disorder with or without agoraphobia as compared to SSRI only.