The cost effectiveness of psychological and pharmacological interventions for social anxiety disorder

A model-based economic analysis

Ifigeneia Mavranezouli, Evan R Mayo-Wilson, Sofia Dias, Kayleigh Kew, David M. Clark, A. E. Ades, Stephen Pilling

Research output: Contribution to journalArticle

Abstract

Background: Social anxiety disorder is one of the most persistent and common anxiety disorders. Individually delivered psychological therapies are the most effective treatment options for adults with social anxiety disorder, but they are associated with high intervention costs. Therefore, the objective of this study was to assess the relative cost effectiveness of a variety of psychological and pharmacological interventions for adults with social anxiety disorder. Methods: A decision-analytic model was constructed to compare costs and quality adjusted life years (QALYs) of 28 interventions for social anxiety disorder from the perspective of the British National Health Service and personal social services. Efficacy data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published literature and national sources, supplemented by expert opinion. Results: Individual cognitive therapy was the most cost-effective intervention for adults with social anxiety disorder, followed by generic individual cognitive behavioural therapy (CBT), phenelzine and book-based self-help without support. Other drugs, group-based psychological interventions and other individually delivered psychological interventions were less cost-effective. Results were influenced by limited evidence suggesting superiority of psychological interventions over drugs in retaining long-term effects. The analysis did not take into account side effects of drugs. Conclusion: Various forms of individually delivered CBT appear to be the most cost-effective options for the treatment of adults with social anxiety disorder. Consideration of side effects of drugs would only strengthen this conclusion, as it would improve even further the cost effectiveness of individually delivered CBT relative to phenelzine, which was the next most cost-effective option, due to the serious side effects associated with phenelzine. Further research needs to determine more accurately the long-term comparative benefits and harms of psychological and pharmacological interventions for social anxiety disorder and establish their relative cost effectiveness with greater certainty.

Original languageEnglish (US)
Article numbere0140704
JournalPLoS One
Volume10
Issue number10
DOIs
StatePublished - Oct 27 2015

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Economic Models
Economic analysis
cost effectiveness
anxiety
Cost effectiveness
economic analysis
Cost-Benefit Analysis
Phenelzine
Pharmacology
Psychology
Cognitive Therapy
Costs and Cost Analysis
Costs
therapeutics
drugs
Pharmaceutical Preparations
Drug-Related Side Effects and Adverse Reactions
adverse effects
State Medicine
quality-adjusted life year

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Mavranezouli, I., Mayo-Wilson, E. R., Dias, S., Kew, K., Clark, D. M., Ades, A. E., & Pilling, S. (2015). The cost effectiveness of psychological and pharmacological interventions for social anxiety disorder: A model-based economic analysis. PLoS One, 10(10), [e0140704]. https://doi.org/10.1371/journal.pone.0140704

The cost effectiveness of psychological and pharmacological interventions for social anxiety disorder : A model-based economic analysis. / Mavranezouli, Ifigeneia; Mayo-Wilson, Evan R; Dias, Sofia; Kew, Kayleigh; Clark, David M.; Ades, A. E.; Pilling, Stephen.

In: PLoS One, Vol. 10, No. 10, e0140704, 27.10.2015.

Research output: Contribution to journalArticle

Mavranezouli, Ifigeneia ; Mayo-Wilson, Evan R ; Dias, Sofia ; Kew, Kayleigh ; Clark, David M. ; Ades, A. E. ; Pilling, Stephen. / The cost effectiveness of psychological and pharmacological interventions for social anxiety disorder : A model-based economic analysis. In: PLoS One. 2015 ; Vol. 10, No. 10.
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