Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients

Eur J Health Econ. 2011 Oct;12(5):489-97. doi: 10.1007/s10198-010-0266-y. Epub 2010 Aug 6.

Abstract

Anxiety and fear are often associated with chronic conditions such as cancer. This paper targets the cost-effectiveness analysis of a cognitive-behavioral group therapy (CBT) in comparison to a client-centered, supportive-experiential group therapy (SET) in cancer patients with dysfunctional fear of progression. An incremental cost-effectiveness analysis was performed using data from a randomized controlled trial among cancer patients receiving inpatient rehabilitation. The means, 95% confidence intervals [95% CI], incremental cost-effectiveness graphic and acceptability curve were obtained from 1,000 bootstrap replications. A total of 174 patients were included in the economic evaluation. The estimated means [95% CI] of direct costs and reduction of fear of progression were <euro>9,045.03 [6,359.07; 12,091.87] and 1.41 [0.93; 1.92] for patients in the SET and <euro>6,682.78 [4,998.09; 8,440.95] and 1.44 [1.02; 1.09] for patients in the CBT. The incremental cost-effectiveness ratio [95% CI] amounts to minus <euro>78,741.66 [-154,987.20; 110,486.32] for an additional unit of effect. Given the acceptability curve, there is a 92.4% chance that the CBT, compared with the SET, is cost-effective without the need of additional costs to payers. Our main result is the superior cost-effectiveness of the cognitive-behavioral intervention program in comparison to the non-directive encounter group for our sample of cancer patients with high levels of anxiety.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / economics*
  • Cost-Benefit Analysis
  • Disease Progression*
  • Fear / psychology*
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Surveys and Questionnaires
  • Treatment Outcome