Groessl Erik J, Rutledge Thomas R
VA San Diego Healthcare System, San Diego, CA, United States of America.
Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, United States of America.
PLoS One. 2025 Feb 6;20(2):e0316995. doi: 10.1371/journal.pone.0316995. eCollection 2025.
A recent trial found that Transcendental Meditation (TM) was an effective non-trauma focused treatment for veterans with Post-Traumatic Stress Disorder (PTSD). The objective of this analysis was to examine the cost-effectiveness of TM for PTSD based on the trial results.
Between 2013-2017, 203 veterans with PTSD were randomized to either TM, Prolonged Exposure (PE), or to a PTSD health education (HE) control. Each group received 12 treatment sessions over 12 weeks. Results indicated that TM was non-inferior to PE for improving PTSD outcomes and both TM and PE were superior to HE, as hypothesized. The proportion of participants with a clinically significant improvement on the CAPS (≥10 point reduction) were TM = 61%, PE = 42%, and HE = 32%. A Markov model was developed to estimate the cost-effectiveness of TM, using the trial effectiveness data. Intervention costs, health care costs, and health utility values associated with response and non-response were derived from scientific literature. Costs were viewed from an organizational perspective and a 5-year time horizon (20 3-month cycles). One-way and probabilistic sensitivity analyses were conducted.
TM was the dominant treatment strategy over both PE and HE in the cost-effectiveness analysis. TM cost an estimated $1504/12 sessions while PE and HE cost $2,822 and $492, respectively. The higher health care costs associated with non-response to therapy offset intervention cost differences. Findings were robust to variability.
In summary, using data from a recent RCT, TM was found to both improve health outcomes and reduce total costs in this analysis. Based on these results, further effectiveness trials and wider adoption of TM should be considered.
最近一项试验发现，超觉静坐法（TM）是一种针对创伤后应激障碍（PTSD）退伍军人的有效的非创伤性治疗方法。本分析的目的是根据试验结果检验TM治疗PTSD的成本效益。
在2013年至2017年期间，203名患有PTSD的退伍军人被随机分为TM组、延长暴露疗法（PE）组或PTSD健康教育（HE）对照组。每组在12周内接受12次治疗。结果表明，在改善PTSD结果方面，TM不劣于PE，并且正如假设的那样，TM和PE均优于HE。临床总体印象量表（CAPS）上有临床显著改善（降低≥10分）的参与者比例分别为：TM组=61%，PE组=42%，HE组=32%。利用试验有效性数据建立了一个马尔可夫模型，以估计TM的成本效益。与反应和无反应相关的干预成本、医疗保健成本和健康效用值均来自科学文献。从组织角度和5年时间范围（20个3个月周期）看待成本。进行了单向和概率敏感性分析。
在成本效益分析中，TM是优于PE和HE的主要治疗策略。TM估计每次12次治疗花费1504美元，而PE和HE分别花费2822美元和492美元。与治疗无反应相关的较高医疗保健成本抵消了干预成本差异。研究结果对变异性具有稳健性。
总之，根据最近一项随机对照试验的数据，在本分析中发现TM既能改善健康结果又能降低总成本。基于这些结果，应考虑进一步进行有效性试验并更广泛地采用TM。
