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Cost-effectiveness analysis of an occupational therapy-led lifestyle approach and routine general practitioners care for panic disorder
Social Psychiatry and Psychiatric Epidemiology, 08/28/09

Lambert RA et al. – If the maximum willingness to pay per additional QALY is £30,000, then there is an 86% chance that a lifestyle intervention may be considered to be value–for–money over 10 months.

Exclusive Author Commentary
Rodney A. Lambert, 08/29/09

The burden of mental health disorders is considerable, and estimated at over £77 billion per year [3]. Cost-effective interventions are necessary to alleviate some of these burdens. Habitual lifestyle behaviours influence mood, although to date mainly single lifestyle factor trials have been conducted to examine the effects on anxiety. An economic evaluation was conducted alongside an unblinded pragmatic randomised controlled trial with assessment at 5 and 10 months. Clinical results have been reported separately [1;2]. Costs and consequences, as measured by the Beck anxiety inventory (BAI) and quality adjusted life years (QALYs), were compared using incremental cost-effectiveness ratios (ICERs).The occupational therapy-led lifestyle intervention was more costly than routine GP care at both 5 and10 months. Significant outcome improvements were evident at 5 months when using the BAI, although these were not maintained at 10 months. Small differences in mean QALYs were found. The estimated ICER was £36 per BAI improvement for 5 months and £39 for 10 months, and £18,905 per QALY gained for 5 months and £8,283 for 10 months. Reference List 1. Lambert,R., Caan,W., and McVicar,A. (2008): Lifestyle and GP care influences on the symptom profile of people with panic disorder. Journal of Public Mental Health, 7:18-24. 2. Lambert,R.A., Harvey,I., and Poland,F. (2007): A pragmatic, unblinded randomised controlled trial comparing an occupational therapy-led lifestyle approach and routine GP care for panic disorder treatment in primary care. Journal of Affective Disorders, 99:63-71. 3. The Sainsbury Centre for Mental Health. The economic and social costs of mental illness. Policy Paper 3. 2003. London, The Sainsbury Centre for Mental Health.

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