Economic evaluation of mindfulness group therapy for patients with depression, anxiety, stress and adjustment disorders compared with treatment as usual

• Published in: British journal of psychiatry Vol. 216; no. 4; pp. 197 - 203
• Main Authors: Saha, Sanjib, Jarl, Johan, Gerdtham, Ulf-G, Sundquist, Kristina, Sundquist, Jan
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.04.2020
• Subjects: Adjustment disorder; Adjustment Disorders - economics; Adult; Anxiety; Anxiety Disorders - economics; Bootstrap method; Cognitive ability; Cognitive-behavioral factors; Cost analysis; Cost of Illness; Cost-Benefit Analysis; Depressive Disorder - economics; Diagnosis; Drugs; Female; Group therapy; Health care; Health Care Costs - statistics & numerical data; Health Care Service and Management, Health Policy and Services and Health Economy; Health Sciences; Humans; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Hälsovetenskap; Intervention; Male; Medical and Health Sciences; Medical diagnosis; Medicin och hälsovetenskap; Mental depression; Middle Aged; Mindfulness; Mindfulness - economics; Productivity; Program Evaluation; Psychiatrists; Psychiatry; Psychotherapy; Psychotherapy, Group - economics; Quality adjusted life years; Questionnaires; Savings; Sick leave; Stress; Stress, Psychological - economics; Uncertainty; Sweden; mindfulness group therapy; Economic evaluation; cognitive behavioural therapy
• ISSN: 0007-1250; 1472-1465; 1472-1465
• DOI: 10.1192/bjp.2018.247

A randomised controlled trial found that a structured mindfulness group therapy (MGT) programme was as effective as treatment as usual (mostly cognitive-behavioural therapy) for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden (ClinicalTrials.gov: NCT01476371). To perform a cost-effectiveness analysis of MGT compared with treatment as usual from both a healthcare and a societal perspective for the trial duration (8 weeks). The costs from a healthcare perspective included treatment as usual, medication and costs for providing MGT. The societal perspective included costs from the healthcare perspective plus savings from productivity gains for the trial duration. The effectiveness was measured as quality-adjusted life-years (QALY) using the EQ-5D-5L questionnaire and the UK value set. Uncertainty surrounding the incremental costs and effects were estimated using non-parametric bootstrapping with 5000 replications and presented with 95% confidence intervals and cost-effectiveness acceptability curves. The MGT group had significantly lower healthcare and societal costs (mean differences -€115 (95% CI -193 to -36) and -€112 (95% CI -207 to -17), respectively) compared with the control group. In terms of effectiveness, there was no significant difference in QALY gain (mean difference -0.003, 95% CI -0.0076 to 0.0012) between the two groups. MGT is a cost-saving alternative to treatment as usual over the trial duration from both a healthcare and a societal perspective for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden.