Abstract
Objectives: Using survey data, this study produces estimates of the cost, effectiveness, and cost-effectiveness of complementary and alternative medicine combined with traditional therapies (pharmacotherapy and/or psychotherapy) in the treatment of anxiety disorders. Unlike past cost-effectiveness analyses that use a narrow definition or randomized controlled trials, this study uses a broad definition of complementary and alternative medicines and survey data to assess the cost-effectiveness. Study Desi and Outcome Measures: This analysis uses the Medical Expenditure Panel Survey (MEPS), an overlapping panel survey of medical use, expenditure, and health status for the civilian non-institutionalized U.S. population to identity economic costs and effects for individuals with anxiety disorders. The primary measure of effect is based on self-perceived mental health status. Cost-effectiveness is determined by estimation of incremental net benefit method. Potential self-selection bias is investigated using observable characteristics and inverse propensity score weighting. Results: Complementary and alternative medicine users with an anxiety disorder showed a statistically insignificant decrease in costs compared to nonusers ($458.95 versus $467.03; p-value 0.920). Complementary and alternative medicine expenditures were offset by a statistically significant decrease in office-based and pharmaceutical costs. Complementary and alternative medicine users showed an increase in the probability of steady or improved mental health compared to nonusers (0.7549 versus 0.6912; p-value 0.190) resulting in an incremental cost-effectiveness ratio of -$12.70 per 10% increase in the probability of steady or increased mental health. The evidence suggests a high probability that complementary and alternative medicine is cost-effective for large values of effect for anxiety disorders (p-value 0.080 for WTP of $5000). Conclusions: This survey data indicates complementary and alternative medicine users with anxiety disorders had slightly lower costs and improved outcomes. Limitations are considered.
Highlights
Anxiety and depression have a significant global prevalence (22.0%) and are associated with some of the most significant impacts on quality of life [1]
Complementary and alternative medicine users with an anxiety disorder showed a statistically insignificant decrease in costs compared to nonusers ($458.95 versus $467.03; p-value 0.920)
Complementary and alternative medicine users showed an increase in the probability of steady or improved mental health compared to nonusers (0.7549 versus 0.6912; p-value 0.190) resulting in an incremental cost-effectiveness ratio of -$12.70 per 10% increase in the probability of steady or increased mental health
Summary
Anxiety and depression have a significant global prevalence (22.0%) and are associated with some of the most significant impacts on quality of life [1]. A large-scale nationally representative survey estimated 12month prevalence for any mental health disorder at over 25% of the US adult population with anxiety disorders and mood disorders (depression disorder and bipolar disorder) with high rates of prevalence (18.1% and 9.5% respectively) [2]. Conventional treatments for anxiety disorders include medication or cognitive-behavioral therapy (CBT). Medications cannot cure anxiety disorders, but can keep them under control while receiving psychotherapy [4]. In CBT patients change their thinking patterns that support their fears and change the way they react to anxiety-provoking situations. Similar to many Complementary and alternative medicine (CAM) modalities, CBT may often incorporate deep-breathing exercises to relieve anxiety and encourage relaxation
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