A cost-utility analysis of psychoanaysis versus psychoanalytic psychotherapy

作者：Berghout Caspar C^*; Zevalkink Jolien; Hakkaart van Roijen Leona

来源：International Journal of Technology Assessment in Health Care, 2010, 26(1): 3-10.

DOI：10.1017/S0266462309990791

• Cost-utility
• Psychoanalysis
• Psychoanalytic psychotherapy
• Long-term
• Cost-effectiveness

Objectives: Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy.
Methods: Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent.
Results: Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER-that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy-was estimated at (sic)52,384 per QALY gained.
Conclusions: Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

• 出版日期2010-1