简短心理动力人际治疗对多重躯体形式障碍患者的经济学评价。
Economic evaluation of brief psychodynamic interpersonal therapy in patients with multisomatoform disorder.
作者信息
Chernyak Nadja, Sattel Heribert, Scheer Marsel, Baechle Christina, Kruse Johannes, Henningsen Peter, Icks Andrea
机构信息
Department of Public Health, Faculty of Medicine, Heinrich-Heine University Duesseldorf; German Diabetes Center, Institute of Biometrics and Epidemiology, Duesseldorf, Germany.
Department of Psychosomatic Medicine and Psychotherapy: Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
出版信息
PLoS One. 2014 Jan 22;9(1):e83894. doi: 10.1371/journal.pone.0083894. eCollection 2014.
BACKGROUND
A brief psychodynamic interpersonal therapy (PIT) in patients with multisomatoform disorder has been recently shown to improve health-related quality of life.
AIMS
To assess cost-effectiveness of PIT compared to enhanced medical care in patients with multisomatoform disorder.
METHOD
An economic evaluation alongside a randomised controlled trial (International Standard Randomised Controlled Trial Number ISRCTN23215121) conducted in 6 German academic outpatient centres was performed. Incremental cost-effectiveness ratio (ICER) was calculated from the statutory health insurance perspective on the basis of quality adjusted life years (QALYs) gained at 12 months. Uncertainty surrounding the cost-effectiveness of PIT was presented by means of a cost-effectiveness acceptability curve.
RESULTS
Based on the complete-case analysis ICER was 41840 Euro per QALY. The results did not change greatly with the use of multiple imputation (ICER = 44222) and last observation carried forward (LOCF) approach to missing data (ICER = 46663). The probability of PIT being cost-effective exceeded 50% for thresholds of willingness to pay over 35 thousand Euros per QALY.
CONCLUSIONS
Cost-effectiveness of PIT is highly uncertain for thresholds of willingness to pay under 35 thousand Euros per QALY.
背景
最近研究表明，针对多重躯体形式障碍患者的简短心理动力人际治疗（PIT）可改善健康相关生活质量。
目的
评估在多重躯体形式障碍患者中，与强化医疗护理相比，PIT的成本效益。
方法
在6个德国学术门诊中心进行了一项经济评估，并开展了一项随机对照试验（国际标准随机对照试验编号ISRCTN23215121）。从法定健康保险角度，根据12个月时获得的质量调整生命年（QALY）计算增量成本效益比（ICER）。通过成本效益可接受性曲线呈现PIT成本效益的不确定性。
结果
基于完整病例分析，ICER为每QALY 41840欧元。使用多重填补法（ICER = 44222）和末次观察结转（LOCF）方法处理缺失数据时（ICER = 46663），结果变化不大。对于每QALY支付意愿阈值超过35000欧元的情况，PIT具有成本效益的概率超过50%。
结论
对于每QALY支付意愿阈值低于35000欧元的情况，PIT的成本效益高度不确定。
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