TY - JOUR
T1 - Cost-Effectiveness of Specialized Treatment Based on Cognitive Behavioral Therapy Versus Usual Care for Tinnitus
AU - Maes, I.H.L.
AU - Cima, R.F.F.
AU - Anteunis, L.J.C.
AU - Scheijen, D.J.W.M.
AU - Baguley, D.M.
AU - el Refaie, A.
AU - Vlaeyen, J.W.
AU - Joore, M.A.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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.
AB - 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.
U2 - 10.1097/MAO.0000000000000331
DO - 10.1097/MAO.0000000000000331
M3 - Article
C2 - 24829038
SN - 1531-7129
VL - 35
SP - 787
EP - 795
JO - Otology & Neurotology
JF - Otology & Neurotology
IS - 5
ER -