COST-EFFECTIVENESS OF ACUPUNCTURE TREATMENT COMPARED TO PLACEBO IN VETERANS WITH COMBAT-RELATED POSTTRAUMATIC STRESS DISORDER (PTSD)
Author(s)
Divya Jain, PharmD, MS, RPh.
Genentech, South San Francisco, CA, USA.
Genentech, South San Francisco, CA, USA.
OBJECTIVES: Post-Traumatic Stress Disorder (PTSD) is under-treated in the United States, leading to high economic and clinical burden. The objective of this model was to evaluate the cost-effectiveness of acupuncture treatment compared to placebo in PTSD patients over a lifetime horizon.
METHODS: The efficacy estimates for acupuncture came from the “Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial”. The cost of 24 acupuncture sessions was assumed to be $3,319. We developed a decision tree to allocate patients into a 5-state post-intervention Markov cohort model (Asymptomatic, Mild, Moderate, Severe, and Death). Outcomes were extrapolated over a lifetime horizon with a cycle length of one year. We used a healthcare system perspective and included direct medical care costs only. Outcomes included total costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs).
RESULTS: Over a lifetime horizon, acupuncture treatment resulted in 16.38 QALYs while Placebo had 15.41 QALYs for an incremental difference of 0.97 in acupuncture’s favor. The cost of Acupuncture was estimated to be $325,718, placebo was valued at $302,880, and the incremental cost of acupuncture was $22,838 over a lifetime. Acupuncture treatment for PTSD was found to be cost-effective at an ICER of $23,426 per QALY. Key drivers of changes in QALYs include post-intervention proportions of patients allocated to PTSD severity levels and health utility scores by severity level. Key drivers of changes in direct medical costs and the ICER include costs of acupuncture and post-intervention proportions of patients allocated to PTSD severity levels.
CONCLUSIONS: Health plans can help their PTSD patients and reduce future costs by expanding access to acupuncture and encouraging patients to consider acupuncture sessions before approving more costly treatments. One limitation to this study was the comparison of acupuncture to placebo; future research should include an active comparator.
METHODS: The efficacy estimates for acupuncture came from the “Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial”. The cost of 24 acupuncture sessions was assumed to be $3,319. We developed a decision tree to allocate patients into a 5-state post-intervention Markov cohort model (Asymptomatic, Mild, Moderate, Severe, and Death). Outcomes were extrapolated over a lifetime horizon with a cycle length of one year. We used a healthcare system perspective and included direct medical care costs only. Outcomes included total costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs).
RESULTS: Over a lifetime horizon, acupuncture treatment resulted in 16.38 QALYs while Placebo had 15.41 QALYs for an incremental difference of 0.97 in acupuncture’s favor. The cost of Acupuncture was estimated to be $325,718, placebo was valued at $302,880, and the incremental cost of acupuncture was $22,838 over a lifetime. Acupuncture treatment for PTSD was found to be cost-effective at an ICER of $23,426 per QALY. Key drivers of changes in QALYs include post-intervention proportions of patients allocated to PTSD severity levels and health utility scores by severity level. Key drivers of changes in direct medical costs and the ICER include costs of acupuncture and post-intervention proportions of patients allocated to PTSD severity levels.
CONCLUSIONS: Health plans can help their PTSD patients and reduce future costs by expanding access to acupuncture and encouraging patients to consider acupuncture sessions before approving more costly treatments. One limitation to this study was the comparison of acupuncture to placebo; future research should include an active comparator.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE126
Topic
Economic Evaluation