Skip to main content
Erschienen in: The European Journal of Health Economics 5/2011

01.10.2011 | Original Paper

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

verfasst von: C. Sabariego, M. Brach, P. Herschbach, P. Berg, G. Stucki

Erschienen in: The European Journal of Health Economics | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

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 €9,045.03 [6,359.07; 12,091.87] and 1.41 [0.93; 1.92] for patients in the SET and €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 €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.
Literatur
1.
Zurück zum Zitat Hoffman, D.L., Dukes, E.M., Wittchen, H.U.: Human and economic burden of generalized anxiety disorder. Depress Anxiety, 1091–4269 (2006) Hoffman, D.L., Dukes, E.M., Wittchen, H.U.: Human and economic burden of generalized anxiety disorder. Depress Anxiety, 1091–4269 (2006)
2.
Zurück zum Zitat Andlin-Sobocki, P., Wittchen, H.U.: Cost of anxiety disorders in Europe. Eur. J. Neurol. 12(Suppl 1), 39–44 (2005)PubMedCrossRef Andlin-Sobocki, P., Wittchen, H.U.: Cost of anxiety disorders in Europe. Eur. J. Neurol. 12(Suppl 1), 39–44 (2005)PubMedCrossRef
3.
Zurück zum Zitat Wittchen, H.U.: Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety 16, 162–171 (2002)PubMedCrossRef Wittchen, H.U.: Generalized anxiety disorder: prevalence, burden, and cost to society. Depress Anxiety 16, 162–171 (2002)PubMedCrossRef
4.
Zurück zum Zitat Herschbach, P., Berg, P., Dankert, A., Duran, G., Engst-Hastreiter, U., Waadt, S., Keller, M., Ukat, R., Henrich, G.: Fear of progression in chronic diseases: psychometric properties of the fear of progression questionnaire. J. Psychsom. Res. 58, 505–511 (2005)CrossRef Herschbach, P., Berg, P., Dankert, A., Duran, G., Engst-Hastreiter, U., Waadt, S., Keller, M., Ukat, R., Henrich, G.: Fear of progression in chronic diseases: psychometric properties of the fear of progression questionnaire. J. Psychsom. Res. 58, 505–511 (2005)CrossRef
5.
Zurück zum Zitat Sheard, T., Maguire, P.: The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. Br. J. Cancer 80, 1770–1780 (1999)PubMedCrossRef Sheard, T., Maguire, P.: The effect of psychological interventions on anxiety and depression in cancer patients: results of two meta-analyses. Br. J. Cancer 80, 1770–1780 (1999)PubMedCrossRef
6.
Zurück zum Zitat Meyer, T.J., Mark, M.M.: Effects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments. Health Psychol. 14, 101–108 (1995)PubMedCrossRef Meyer, T.J., Mark, M.M.: Effects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments. Health Psychol. 14, 101–108 (1995)PubMedCrossRef
7.
Zurück zum Zitat Newell, S.A., Sanson-Fisher, R.W., Savolainen, N.J.: Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J. Natl Cancer Inst. 94, 558–584 (2002)PubMed Newell, S.A., Sanson-Fisher, R.W., Savolainen, N.J.: Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J. Natl Cancer Inst. 94, 558–584 (2002)PubMed
8.
Zurück zum Zitat Owen, J.E., Klapow, J.C., Hicken, B., Tucker, D.C.: Psychosocial interventions for cancer: review and analysis using a three-tiered outcomes model. Psychooncology 10, 218–230 (2001)PubMedCrossRef Owen, J.E., Klapow, J.C., Hicken, B., Tucker, D.C.: Psychosocial interventions for cancer: review and analysis using a three-tiered outcomes model. Psychooncology 10, 218–230 (2001)PubMedCrossRef
9.
Zurück zum Zitat Herschbach, P., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., Henrich, G., Book, K., Dinkel, A.: Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer. Psychother. Psychosom. 79, 31–38 (2010)PubMedCrossRef Herschbach, P., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., Henrich, G., Book, K., Dinkel, A.: Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer. Psychother. Psychosom. 79, 31–38 (2010)PubMedCrossRef
10.
Zurück zum Zitat Herschbach, P., Book, K., Dinkel, A., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., Henrich, G.: Evaluation of two group therapies to reduce fear of progression in cancer patients. Support. Care Cancer 18, 471–479 (2010)PubMedCrossRef Herschbach, P., Book, K., Dinkel, A., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., Henrich, G.: Evaluation of two group therapies to reduce fear of progression in cancer patients. Support. Care Cancer 18, 471–479 (2010)PubMedCrossRef
11.
Zurück zum Zitat Rosenberg, H.J., Rosenberg, S.D., Ernstoff, M.S., Wolford, G.L., Amdur, R.J., Elshamy, M.R., Bauer-Wu, S.M., Ahles, T.A., Pennebaker, J.W.: Expressive disclosure and health outcomes in a prostate cancer population. Int. J. Psychiatry Med. 32, 37–53 (2002)PubMedCrossRef Rosenberg, H.J., Rosenberg, S.D., Ernstoff, M.S., Wolford, G.L., Amdur, R.J., Elshamy, M.R., Bauer-Wu, S.M., Ahles, T.A., Pennebaker, J.W.: Expressive disclosure and health outcomes in a prostate cancer population. Int. J. Psychiatry Med. 32, 37–53 (2002)PubMedCrossRef
12.
Zurück zum Zitat Simpson, J.S., Carlson, L.E., Trew, M.E.: Effect of group therapy for breast cancer on healthcare utilization. Cancer Pract. 9, 19–26 (2001)PubMedCrossRef Simpson, J.S., Carlson, L.E., Trew, M.E.: Effect of group therapy for breast cancer on healthcare utilization. Cancer Pract. 9, 19–26 (2001)PubMedCrossRef
13.
Zurück zum Zitat Mehnert, A., Herschbach, P., Berg, P., Henrich, G., Koch, U.: Fear of progression in breast cancer patients—validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF). Z. Psychosom. Med. Psychother. 52, 274–288 (2006)PubMed Mehnert, A., Herschbach, P., Berg, P., Henrich, G., Koch, U.: Fear of progression in breast cancer patients—validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF). Z. Psychosom. Med. Psychother. 52, 274–288 (2006)PubMed
14.
Zurück zum Zitat Herschbach, P., Duran, G., Engst-Rastreiter, U., Waadt, S., Berg, P.: Gruppentherapetische Behandlung von Progredienzangst bei Krebspatienten. Verhaltenstherapie Verhaltensmedizin 27, 298–309 (2006) Herschbach, P., Duran, G., Engst-Rastreiter, U., Waadt, S., Berg, P.: Gruppentherapetische Behandlung von Progredienzangst bei Krebspatienten. Verhaltenstherapie Verhaltensmedizin 27, 298–309 (2006)
15.
Zurück zum Zitat Hessel, F., Wittman, M., Petro, W., Wasem, J.: Methoden zur Kostenerfassungim Rahmen der ökonomischen Evaluation einer Rehabilitations-maßnahme bei chronischen Atemwegserkrankungen. Pneumologie 54, 289–295 (2002)CrossRef Hessel, F., Wittman, M., Petro, W., Wasem, J.: Methoden zur Kostenerfassungim Rahmen der ökonomischen Evaluation einer Rehabilitations-maßnahme bei chronischen Atemwegserkrankungen. Pneumologie 54, 289–295 (2002)CrossRef
16.
Zurück zum Zitat Rote-Liste: Rote Liste Service GmbH. In: ECV Verlag, Frankfurt (2004) Rote-Liste: Rote Liste Service GmbH. In: ECV Verlag, Frankfurt (2004)
17.
Zurück zum Zitat AOK: Vergütungsliste für Orthopädische Hilfsmittel der Primärkassen in Bayern (2004) AOK: Vergütungsliste für Orthopädische Hilfsmittel der Primärkassen in Bayern (2004)
18.
Zurück zum Zitat Krauth, C., Hessel, F., Hansmeier, T., Wasem, J., Seitz, R., Schweikert, B.: Empirical standard costs for health economic evaluation in Germany—a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67, 736–746 (2005)PubMedCrossRef Krauth, C., Hessel, F., Hansmeier, T., Wasem, J., Seitz, R., Schweikert, B.: Empirical standard costs for health economic evaluation in Germany—a proposal by the working group methods in health economic evaluation. Gesundheitswesen 67, 736–746 (2005)PubMedCrossRef
19.
Zurück zum Zitat Gandek, B., Ware, J.E., Aaronson, N.K., Apolone, G., Bjorner, J.B., Brazier, J.E., Bullinger, M., Kaasa, S., Leplege, A., Prieto, L., Sullivan, M.: Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. International quality of life assessment. J. Clin. Epidemiol. 51, 1171–1178 (1998)PubMedCrossRef Gandek, B., Ware, J.E., Aaronson, N.K., Apolone, G., Bjorner, J.B., Brazier, J.E., Bullinger, M., Kaasa, S., Leplege, A., Prieto, L., Sullivan, M.: Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. International quality of life assessment. J. Clin. Epidemiol. 51, 1171–1178 (1998)PubMedCrossRef
20.
Zurück zum Zitat Barber, J.A., Thompson, S.G.: Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat. Med. 19, 3219–3236 (2000)PubMedCrossRef Barber, J.A., Thompson, S.G.: Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Stat. Med. 19, 3219–3236 (2000)PubMedCrossRef
21.
Zurück zum Zitat Carpenter, J., Bithell, J.: Bootstrap confidence intervals: when, which, what? A practical guide for medical statisticians. Stat. Med. 19, 1141–1164 (2000)PubMedCrossRef Carpenter, J., Bithell, J.: Bootstrap confidence intervals: when, which, what? A practical guide for medical statisticians. Stat. Med. 19, 1141–1164 (2000)PubMedCrossRef
22.
Zurück zum Zitat Drummond, M.F., O’Brien, B., Stoddart, G.L., Torrance, G.W.: Methods for the Economic Evaluation of Health Care Programmes, 2nd edn. Oxford Medical Publications, New York (1997) Drummond, M.F., O’Brien, B., Stoddart, G.L., Torrance, G.W.: Methods for the Economic Evaluation of Health Care Programmes, 2nd edn. Oxford Medical Publications, New York (1997)
23.
Zurück zum Zitat Briggs, A.H.: Statistical approaches to handling uncertainty in health economic evaluation. Eur. J. Gastroenterol. Hepatol. 16, 551–561 (2004)PubMedCrossRef Briggs, A.H.: Statistical approaches to handling uncertainty in health economic evaluation. Eur. J. Gastroenterol. Hepatol. 16, 551–561 (2004)PubMedCrossRef
24.
Zurück zum Zitat Chiles, J.A., Lambert, M.J., Michael, J., Hatch Arlin, L.: The impact of psychological interventions on medical cost offset: a meta-analytic review. Clin. Psychol. Sci. Prax. 6, 204–220 (1999)CrossRef Chiles, J.A., Lambert, M.J., Michael, J., Hatch Arlin, L.: The impact of psychological interventions on medical cost offset: a meta-analytic review. Clin. Psychol. Sci. Prax. 6, 204–220 (1999)CrossRef
25.
Zurück zum Zitat Knapp, M., Thorgrimsen, L., Patel, A., Spector, A., Hallam, A., Woods, B., Orrell, M.: Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis. Br. J. Psychiatry 188, 574–580 (2006)PubMedCrossRef Knapp, M., Thorgrimsen, L., Patel, A., Spector, A., Hallam, A., Woods, B., Orrell, M.: Cognitive stimulation therapy for people with dementia: cost-effectiveness analysis. Br. J. Psychiatry 188, 574–580 (2006)PubMedCrossRef
26.
Zurück zum Zitat Briggs, A.: Economic evaluation and clinical trials: size matters. BMJ 321, 1362–1363 (2000)PubMedCrossRef Briggs, A.: Economic evaluation and clinical trials: size matters. BMJ 321, 1362–1363 (2000)PubMedCrossRef
27.
Zurück zum Zitat Briggs, A., Fenn, P.: Confidence intervals or surfaces? Uncertainty on the cost-effectiveness plane. Health Econ. 7, 723–740 (1998)PubMedCrossRef Briggs, A., Fenn, P.: Confidence intervals or surfaces? Uncertainty on the cost-effectiveness plane. Health Econ. 7, 723–740 (1998)PubMedCrossRef
28.
Zurück zum Zitat Fenwick, E., O’Brien, B.J., Briggs, A.: Cost-effectiveness acceptability curves—facts, fallacies and frequently asked questions. Health Econ. 13, 405–415 (2004)PubMedCrossRef Fenwick, E., O’Brien, B.J., Briggs, A.: Cost-effectiveness acceptability curves—facts, fallacies and frequently asked questions. Health Econ. 13, 405–415 (2004)PubMedCrossRef
29.
Zurück zum Zitat Heuzenroeder, L., Donnelly, M., Haby, M.M., Mihalopoulos, C., Rossell, R., Carter, R., Andrews, G., Vos, T.: Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder. Aust. N. Z. J. Psychiatry 38, 602–612 (2004)PubMedCrossRef Heuzenroeder, L., Donnelly, M., Haby, M.M., Mihalopoulos, C., Rossell, R., Carter, R., Andrews, G., Vos, T.: Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder. Aust. N. Z. J. Psychiatry 38, 602–612 (2004)PubMedCrossRef
30.
Zurück zum Zitat Chuang, L.H., Kind, P.: Converting the SF-12 into the EQ-5D: an empirical comparison of methodologies. Pharmacoeconomics 27, 491–505 (2009)PubMedCrossRef Chuang, L.H., Kind, P.: Converting the SF-12 into the EQ-5D: an empirical comparison of methodologies. Pharmacoeconomics 27, 491–505 (2009)PubMedCrossRef
Metadaten
Titel
Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients
verfasst von
C. Sabariego
M. Brach
P. Herschbach
P. Berg
G. Stucki
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
The European Journal of Health Economics / Ausgabe 5/2011
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-010-0266-y

Weitere Artikel der Ausgabe 5/2011

The European Journal of Health Economics 5/2011 Zur Ausgabe