Cost-Effectiveness of Guided Self-Help Treatment for Recurrent Binge Eating

Frances L. Lynch, Ruth H. Striegel-Moore, John F. Dickerson, Nancy Perrin, Lynn DeBar, G. Terence Wilson, Helena C. Kraemer

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits. Using data from a recent randomized controlled trial, we conducted an incremental cost-effectiveness analysis (CEA) of a cognitive-behavioral therapy guided self-help intervention (CBT-GSH) to treat recurrent binge eating compared to treatment as usual (TAU). Method: Participants were 123 adult members of an HMO (mean age = 37.2 years, 91.9% female, 96.7% non-Hispanic White) who met criteria for eating disorders involving binge eating as measured by the Eating Disorder Examination (C. G. Fairburn & Z. Cooper, 1993). Participants were randomized either to treatment as usual (TAU) or to TAU plus CBT-GSH. The clinical outcomes were binge-free days and quality-adjusted life years (QALYs); total societal cost was estimated using costs to patients and the health plan and related costs. Results: Compared to those receiving TAU only, those who received TAU plus CBT-GSH experienced 25.2 more binge-free days and had lower total societal costs of $427 over 12 months following the intervention (incremental CEA ratio of -$20.23 per binge-free day or -$26,847 per QALY). Lower costs in the TAU plus CBT-GSH group were due to reduced use of TAU services in that group, resulting in lower net costs for the TAU plus CBT group despite the additional cost of CBT-GSH. Conclusions: Findings support CBT-GSH dissemination for recurrent binge-eating treatment.

Original languageEnglish (US)
Pages (from-to)322-333
Number of pages12
JournalJournal of Consulting and Clinical Psychology
Volume78
Issue number3
DOIs
StatePublished - Jun 2010
Externally publishedYes

Keywords

  • binge eating
  • cognitive behavior therapy
  • cost-effectiveness analysis
  • evidence-based treatment programs
  • guided self-help

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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