PharmacoEconomics & Outcomes News 482 - 16 Jul 2005

Cognitive therapy "highly cost-effective" in bipolar disorder

The use of cognitive therapy in combination withmood stabilisers is "highly cost-effective" compared withstandard care alone for patients with relapsing bipolardisorder, according to researchers from the UK.

In their study, 103 outpatients with bipolar disorderwho experienced frequent relapses despite the use ofmood stabilisers were randomly assigned to receivecognitive therapy in addition to mood stabilisers(n = 51) or usual treatment for 30 months. Service useand cost data were collected at 3-month intervals toassess cost effectiveness. Over the whole 30 months,patients who received cognitive therapy spent fewerdays with bipolar episodes than those who receivedusual care (95.3 vs 201 days). This difference wassignificant after the number of previous bipolar episodesand medication compliance were controlled for.

In addition, patients who received cognitive therapyincurred £1300 less per patient in service costs over thestudy period than those who received usual care.* Cost-effectiveness acceptability curves showed that, even ifno value was place on a bipolar-free day, the probabilityof cognitive therapy being more cost effective than usualcare was > 80%. Moreover, even if society was willingto attribute a value of £5 for a bipolar-free day, theprobability of cognitive therapy being cost effectiveversus usual care over 30 months would rise to > 85%,say the researchers.* Costs included those associated with medications, cognitive therapy,community services, and psychiatric inpatient and outpatient care.

Lam DH, et al. Cost-effectiveness of relapse-prevention cognitive therapy forbipolar disorder: 30-month study. British Journal of Psychiatry 186: 500-506, Jun2005 800994902

1

PharmacoEconomics & Outcomes News 16 Jul 2005 No. 4821173-5503/10/0482-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved