Evidence map›Paper›PMID 38811931›Full record

ArticleCost effectiveness and resource allocation : C/E2024

Long-term cost-utility analysis of family therapy vs. treatment as usual for young people seen after self-harm.

Chris Bojke, David Cottrell, Alex Wright-Hughes, Amanda Farrin, Sandy Tubeuf

Abstract read
In one paragraph

Article in Cost effectiveness and resource allocation : C/E, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Chris BojkeLeeds Institute of Health Sciences, Academic Unit of Health Economics, University of Leeds, Leeds, UK.ORCID http://orcid.org/0000-0003-2601-0314
David CottrellLeeds Institute of Health Sciences, University of Leeds, Leeds, UK. d.j.cottrell@leeds.ac.uk.ORCID http://orcid.org/0000-0001-8674-0955
Alex Wright-HughesLeeds Institute of Clinical Trials, University of Leeds, Leeds, UK.ORCID http://orcid.org/0000-0001-8839-6756
Amanda FarrinLeeds Institute of Clinical Trials, University of Leeds, Leeds, UK.ORCID http://orcid.org/0000-0002-2876-0584
Sandy TubeufInstitute of Health and Society, Institute of Social and Economic Research, Université catholique de Louvain, Louvain-la-Neuve, Belgium.ORCID http://orcid.org/0000-0001-9001-1157

Funding

Health Technology Assessment Programme 07/33/01
6 · The paper itself

Abstract

backgroundThe joint evidence of the cost and the effectiveness of family-based therapies is modest.

objectiveTo study the cost-effectiveness of family therapy (FT) versus treatment-as-usual (TAU) for young people seen after self-harm combining data from an 18-month trial and hospital records up to 60-month from randomisation.

methodsWe estimate the cost-effectiveness of FT compared to TAU over 5 years using a quasi-Markov state model based on self-harm hospitalisations where probabilities of belonging in a state are directly estimated from hospital data. The primary outcome is quality-adjusted life years (QALY). Cost perspective is NHS and PSS and includes treatment costs, health care use, and hospital attendances whether it is for self-harm or not. Incremental cost-effectiveness ratios are calculated and deterministic and probabilistic sensitivity analyses are conducted.

resultsBoth trial arms show a significant decrease in hospitalisations over the 60-month follow-up. In the base case scenario, FT participants incur higher costs (mean +£1,693) and negative incremental QALYs (-0.01) than TAU patients. The associated ICER at 5 years is dominated and the incremental health benefit at the £30,000 per QALY threshold is -0.067. Probabilistic Sensitivity Analysis finds the probability that FT is cost-effective is around 3 - 2% up to a maximum willingness to pay of £50,000 per QALY. This suggest that the extension of the data to 60 months show no difference in effectiveness between treatments.

conclusionWhilst extended trial follow-up from routinely collected statistics is useful to improve the modelling of longer-term cost-effectiveness, FT is not cost-effective relative to TAU and dominated in a cost-utility analysis.

Indexed as

AdolescentsCost-effectivenessHospitalisationNHS digitalQALYSelf-harm

Identifiers

PMID38811931
PMCPMC11138073

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Registered trials

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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.