Cost-Effectiveness of Specialized Treatment Based on Cognitive Behavioral Therapy Versus Usual Care for Tinnitus

I.H.L. Maes*, R.F.F. Cima, L.J.C. Anteunis, D.J.W.M. Scheijen, D.M. Baguley, A. el Refaie, J.W. Vlaeyen, M.A. Joore

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: To evaluate the cost-effectiveness of specialized multidisciplinary tinnitus treatment based on cognitive behavioral therapy, compared with care as usual. Design: Randomized controlled trial including an economic evaluation from a health-care and societal perspective, using a one-year time horizon. Setting: Audiologic center. Patients: A referred sample of 626 patients with tinnitus were eligible for participation. Approximately 492 patients were included in the study. Eighty-six (35%) of 247 patients in the usual care group, and 74 (30%) of 245 patients in the specialized care group were lost to follow-up by month 12. Main Outcome Measures: Quality adjusted life years (QALYs) as measured with the Health Utilities Index Mark III and cost in US dollars. Results: Compared with patients receiving usual care, patients who received specialized care gained on average 0.015 QALYs (95% bootstrapped confidence interval [BCI], -0.03 to 0.06). The incremental costs from a societal perspective are $357 (95% BCI, -$1,034 to $1,785). The incremental cost per QALY from a societal perspective amounted to $24,580. The probability that SC is cost-effective from a societal perspective is 58% for a willingness to pay for a QALY of $45,000. Conclusion: Specialized multidisciplinary tinnitus treatment based on cognitive behavioral therapy is cost-effective as compared with usual care. Although uncertainty surrounding the incremental costs and effects is considerable, sensitivity analysis indicated that cost-effectiveness results were robust.
Original languageEnglish
Pages (from-to)787-795
JournalOtology & Neurotology
Issue number5
Publication statusPublished - 1 Jan 2014

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