Trial-based economic evaluation of mindfulness-based cognitive therapy compared to treatment as usual for bipolar disorder.

Abstract

Aim of this study was to assess the cost-effectiveness and cost-utility of mindfulness-based cognitive therapy (MBCT) and treatment as usual (TAU) compared to TAU alone in adults with Bipolar disorder (BD). An economic evaluation with a time horizon of 15months was conducted from a societal perspective. Outcomes were expressed in costs per quality adjusted life years (QALYs) and costs per responder using the inventory of depressive symptomatology clinician rating score. People with BD (N=144) were included in this study. From a societal perspective, the difference of total costs between MBCT+TAU and TAU was €615, with lower costs in the MBCT+TAU group. Only healthcare costs differed significantly between the two groups. A small difference in QALYs in favor of MBCT+TAU was found combined with lower costs (-€836; baseline adjusted) for MBCT+TAU compared to TAU, resulting in a dominant incremental cost-utility ratio. The probability that the MBCT+TAU was cost-effective was 65%. All sensitivity analyses attested to the robustness of the base case analyses. Concludingly, MBCT+TAU seems to be cost-effective compared to TAU alone, indicated by a small or neglectable difference in effect, in favor of MBCT+TAU, while resulting in lower costs.