The Cost-Effectiveness of Cognitive-Behavioral Group Training for Patients with Unexplained Physical Symptoms

Jul 1, 2015, 00:00 AM
Section Title : Economic Evaluation
Section Order : 4
First Page : 570


The aim of the study was to evaluate the cost-effectiveness of a cognitive-behavioral group training compared with a wait-list control for patients with unexplained physical symptoms (UPS).


A probabilistic decision-analytic Markov model was developed with three health states (poor health, average health, and death) based on a cutoff score of the Physical Component Summary of the short-form 36 health survey. To assess the cost-effectiveness in terms of cost per quality-adjusted life-year (QALY), a societal perspective was adopted. The model consisted of cycles of 3 months and a time horizon of 4 years. Data for the model were derived from a randomized controlled trial, in which 162 patients with UPS were randomized either to cognitive-behavioral group training or to the wait-list control. Data were assessed at baseline and after the training of 3 months or after a wait-list period of 3 months. In addition, the training group was followed in an uncontrolled phase and assessed at 3 months and 1 year after the training.


After 4 years, the group training was in terms of cost-effectiveness “dominant” compared with the wait-list control; there was a positive effect of 0.06 QALYs and a €828 reduction in costs. The cost-effectiveness improved with a longer time horizon. A threshold of €30,000/QALY was passed after 18 months. The group training was cost saving after 33 months.


Cognitive-behavioral group training is a cost-effective treatment compared with the wait-list control for patients with UPS.
HEOR Topics :
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Mental Health
  • Specific Diseases & Conditions
Tags :
  • cost-effectiveness
  • quality-adjusted life-year
  • Unexplained physical symptoms
Regions :
  • Africa
  • Eastern and Central Europe
  • Middle East
  • Western Europe