OBJECTIVES

: To assess the cost-effectiveness of therapist guided Internet delivered cognitive behavioral therapy (i-CBT) compared to treatment as usual (TAU) in the management of functional abdominal pain disorders (FAPDs)

METHODS

Ninety children aged 8-12 years, with a diagnosis of irritable bowel syndrome, functional dyspepsia, or functional abdominal pain were randomized to either a treatment consisting of 10 weeks of therapist-guided i-CBT or TAU. The health outcome measure was Paediatric Quality of Life Inventory (PedsQL) scores at baseline and post treatment. The scores on the PedsQL were mapped onto the Child Health Utility 9D (CHU9D) to estimate QALYs. Resource use data were collected using the Treatment Inventory of Costs in Psychiatric Patients (TiC-P) at baseline, 6 weeks and 10 weeks. Cost data for week 6 and week 10 were summed up to estimate the cumulative cost of resource use over the treatment period. We conducted a cost-utility analysis from a societal perspective using regression techniques to assess the mean differences in costs and QALYs between the treatment arms over time.

RESULTS

: I-CBT resulted in 0.0181 QALYs gained while TAU was associated with deterioration in HRQoL, -0.0006 QALYs. The incremental health gain resulted in 0.0187 QALYs between i-CBT and TAU arms.

The mean intervention cost was 177.33 USD. There was a significant reduction in the healthcare resource use of -155.50 USD in the i-CBT arm compared to the TAU arm.

Total mean societal cost to participants randomized to the i-CBT and TAU arms was 2750 USD and 3976 USD respectively, resulting in an incremental cost difference of -1173 USD (1050 USD). The intervention was found to be approximately 86% cost-effective/saving at a willingness to pay of zero

CONCLUSIONS

: I-CBT is a cost-saving approach compare with TAU. It saves about 1200 USD per participant over a ten weeks period and thus presents a worthy investment.