Evidence map›Paper›PMID 29019158›Full record

ArticleHealth economics review2017

Cost-effectiveness of nurse-delivered cognitive behavioural therapy (CBT) compared to supportive listening (SL) for adjustment to multiple sclerosis.

I Mosweu, R Moss-Morris, L Dennison, T Chalder, P McCrone

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health economics review, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Does the inclusion of societal costs change the economic evaluations recommendations? A systematic review for multiple sclerosis disease.The European journal of health economics : HEPAC : health economics in prevention and care · 2023
    Pooled it
  3. Pooled it
  4. Review
  5. Quality of life among chronic myeloid leukemia patients in the second-line treatment with nilotinib and influential factors.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

I MosweuKing's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Box 024, The David Goldberg Centre, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. iris.mosweu@kcl.ac.uk.
R Moss-MorrisDepartment of Psychology, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK.
L DennisonSchool of Psychology, University of Southampton, Southampton, UK.
T ChalderDepartment of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK.
P McCroneKing's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Box 024, The David Goldberg Centre, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
King's College London · GBUniversity of Southampton · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCognitive Behavioural Therapy (CBT) reduces distress in multiple sclerosis, and helps manage adjustment, but cost-effectiveness evidence is lacking.

methodsAn economic evaluation was conducted within a multi-centre trial. 94 patients were randomised to either eight sessions of nurse-led CBT or supportive listening (SL). Costs were calculated from the health, social and indirect care perspectives, and combined with additional quality-adjusted life years (QALY) or improvement on the GHQ-12 score, to explore cost-effectiveness at 12 months.

resultsCBT had higher mean health costs (£1610, 95% CI, -£187 to 3771) and slightly better QALYs (0.0053, 95% CI, -0.059 to 0.103) compared to SL but these differences were not statistically significant. This yielded £301,509 per QALY improvement, indicating that CBT is not cost-effective according to established UK NHS thresholds. The extra cost per patient improvement on the GHQ-12 scale was £821 from the same perspective. Using a £20,000, threshold, CBT in this format has a 9% probability of being cost effective. Although subgroup analysis of patients with clinical levels of distress at baseline showed an improvement in the position of CBT compared to SL, CBT was still not cost-effective.

conclusionNurse delivered CBT is more effective in reducing distress among MS patients compared to SL, but is highly unlikely to be cost-effective using a preference-based measure of health (EQ-5D). Results from a disease-specific measure (GHQ-12) produced comparatively lower Incremental Cost-Effectiveness Ratios, but there is currently no acceptable willingness-to-pay threshold for this measure to guide decision-making.

Indexed as

AnxietyCognitive behavioural therapyCost-effectivenessCostsDistressMultiple sclerosis

Identifiers

PMID29019158
PMCPMC5634991
OpenAlexW2764257704

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.