比较精神科治疗的成本效益：神经性贪食症

Comparing the cost effectiveness of psychiatric treatments: bulimia nervosa.

作者信息

Koran L M, Agras W S, Rossiter E M, Arnow B, Schneider J A, Telch C F, Raeburn S, Bruce B, Perl M, Kraemer H C

机构信息

Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, CA 94305, USA.

出版信息

Psychiatry Res. 1995 Sep 8;58(1):13-21. doi: 10.1016/0165-1781(95)02681-l.

DOI:10.1016/0165-1781(95)02681-l

PMID:8539308

Abstract

We conducted an exploratory post hoc study that compared the cost effectiveness of five treatments for bulimia nervosa: 15 weeks of cognitive behavioral therapy (CB) followed by three monthly sessions, 16 weeks (Med16) and 24 weeks (Med24) of desipramine (< or = 300 mg/day), and CB combined with desipramine for those durations (Combo16 and Combo24). We illustrate how a treatment's cost effectiveness varies according to when evaluation is done and how effectiveness and cost are defined. At 32 weeks, Med16 appears the most cost-effective treatment, and Combo16 appears the least. At 1 year, Med24 appears the most cost-effective treatment, and Combo16 appears the least. Using this post hoc analysis as an example, we discuss the pitfalls and limitations of cost-effectiveness analysis of psychiatric treatments.

摘要

我们开展了一项探索性事后分析研究，比较了五种治疗神经性贪食症方法的成本效益：为期15周的认知行为疗法（CB），之后每月进行三次治疗；16周（Med16）和24周（Med24）的地昔帕明治疗（≤300毫克/天），以及在这些时间段内CB联合地昔帕明治疗（Combo16和Combo24）。我们阐述了一种治疗方法的成本效益如何根据评估时间以及疗效和成本的定义方式而有所不同。在32周时，Med16似乎是最具成本效益的治疗方法，而Combo16似乎是最不具成本效益的。在1年时，Med24似乎是最具成本效益的治疗方法，而Combo16似乎是最不具成本效益的。以这项事后分析为例，我们讨论了精神科治疗成本效益分析的陷阱和局限性。