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closeGET costs more at Saint Bartholomew's Hospital (Barts) (one of the trial centre) than the estimate, meaning therapy there is not cost effective when a QALY is valued at £30,000 in healthcare costs
Posted by tkindlon on 24 Feb 2014 at 20:47 GMT
I previously pointed out that the real cost of CBT at Maudsley Hospital (one of trial centres) is a lot more than the estimated cost, meaning that CBT at Maudsley Hospital is not cost effective at a threshold for healthcare costs of £30,000 per QALY (1).
I also have some data on the cost of GET, although it is not in the exact same form.
McCrone et al. (2) used the following estimate: "The cost per hour of therapy was £110 for CBT and £100 for APT and GET".
They also said: "The healthcare costs per QALY gained for CBT and GET compared to SMC were below the cost-effectiveness threshold of £30,000. The cost of CBT would need to increase by 45% and GET by 22% for the cost per QALY to reach £30,000."
That is to say, £122 per hour of GET is the threshold for GET to be cost effective using a threshold of £30000 in healthcare costs per QALY.
The following is information on the costs of attending Saint Bartholomew's Hospital (Barts) from 2009: The initial consultation is free and if diagnosis is confirmed, 16 sessions are offered at a cost of £4,228. If the patient has not responded, one can keep going at no additional cost.
In the PACE Trial, which was conducted at the same venue, the first session was 90 minutes with subsequent sessions being 50 minutes long (therapist manual). That £100 an hour, that is a cost of £1316.67.
If a 16th session was added, that would be 14 hours, which translates to £1400 at £100 per hour.
I am not sure what the cost of an initial assessment would be but the PACE Trial estimated it at £169 per hour.
These figures clearly suggest that GET at Barts actually costs a lot more than the estimate of £100 per hour and, more importantly, more than £122 per hour, the cost above which treatment is no longer cost effective using a threshold of £30,000 for healthcare costs per QALY.
References:
1. Tpkindlon. "CBT costs £176/session at Maudsley Hospital (one of trial centres). This translates to CBT not being cost effective when a QALY is valued at £30,000 in healthcare costs" http://www.plosone.org/an...
2. McCrone P, Sharpe M, Chalder T, Knapp M, Johnson AL, Goldsmith KA, White PD. Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis. PLoS One. 2012;7(8):e40808. doi: 10.1371/journal.pone.0040808. Epub 2012 Aug 1.