Cost-utility analysis of transdiagnostic [CBT] for people with persistent physical symptoms in contact with specialist service... 2024 McCrone et al

Full title: Cost-utility analysis of transdiagnostic cognitive behavioural therapy for people with persistent physical symptoms in contact with specialist services evaluated in the PRINCE secondary trial

Full list of authors: McCrone, Patel, Hotopf, Moss-Morris, Ashworth, David, Husain, James, Landau, Chalder

Highlights

• CBT for people with persistent physical symptoms increased healthcare costs.
• Health-related quality of life and QALYs were greater with CBT.
• CBT appears to be a cost-effective treatment option.

Abstract

Objective
To compare the cost-utility of transdiagnostic cognitive behavioural therapy (TDT-CBT) plus standardised medical care (SMC) to SMC alone to support people with persistent physical symptoms in contact with specialist services.

Methods
This study compared the cost-utility of TDT-CBT. A two-arm randomised controlled trial was conducted in secondary care settings. Participants received either TDT-CBT + SMC or SMC alone. Measures were taken at baseline and at 9-, 20-, 40-, and 52-week follow-up. Service use was measured, and costs calculated. Costs were combined with quality-adjusted life years (QALYs) based on the EQ-5D-5L using incremental cost-utility ratios with uncertainty addressed using cost-effectiveness planes and acceptability curves.

Results
The costs during the follow-up period were £3473 for TDT-CBT + SMC and £3104 for SMC alone. The incremental cost for TDT-CBT + SMC adjusting for baseline was £482 (95 % CI, −£399 to £1233). QALYs over the follow-up were 0.578 for TDT-CBT + SMC and 0.542 for SMC alone. The incremental QALY was 0.038 (95 % CI, −0.005 to 0.080). The incremental cost per QALY was £12,684 for TDT-CBT + SMC. There was a 68.3 % likelihood that TDT-CBT + SMC was the most cost-effective option at a threshold of £20,000 per QALY.

Conclusion
Adding TDT-CTB to SMC results in slightly increased costs and slightly better outcomes in terms of QALYs. This represents a cost-effective option based on the conventional QALY threshold value.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0022399924003726

 

As impressively delusional as ever, just fiddling around with imaginary numbers. Seems to be the current strategy is to fake numbers in terms of RoI and framing them explicitly as reducing direct health care expenses. Lots of those lately. Hey it's not as if LC alone is estimated in the trillions or anything like that.

They exclude the costs of the interventions, and still it adds to overall costs. I don't know who else can do that, ignore the initial investment, but I guess that when nothing matters, nothing truly matters. Hey, if I ignore the cost of buying the printer and only count the cost of the ink, it's cheaper to buy a new printer. OK actually it costs the same. Do not add all the numbers up, though. Just accept that it's cost-utilitiarian. Even though it's literally useless.

Also here they basically describe cherry-picking, but again nothing matters so whatever:

STOP THE COUNT! If my team is ahead by one goal 15 minutes before the end of the game, it must be marked as a victory. Obviously.

Oh, I love this. Remember how they keep writing about how it's unfair that NICE changed application of CBT as merely supportive?

Wow they must be mad at themselves here, for saying that it's merely supportive and not curative. I guess they'd argue that this is transdiagnostic so not for for CFS, it just happens to also apply to CFS.

Again, nothing matters in this pseudoscience. It's not even that up is down and down is up, it's that they are whatever they need to be at the present moment, including west, red and both hot and cold at the same time. Also, for some reason, 5:55 but only PM, not AM.

Ah, well, nevertheless.

Also, 'specialist' services for 'transdiagnostic', i.e. generic, modalities? They are generic specialists? Specialists of generics? How does that even work?

And as usual they call this a controlled trial when it isn't controlled. Or somehow this wasn't just a randomized trial but also a combined meta analysis and systematic review? Wut? Why those specific 18 trials when there have been hundreds? I sure hope you like cherry pie because they got bushels of them.

So, no reduction in costs. From terrible biased data. Which probably actually means an increase in costs, given who we are talking about here. And examples such as this nonsense study where they exclude the cost of the intervention by only counting post-intervention costs. Things you can only do when you are exempt from making sense or respecting norms.

They 'developed' another model?

Which is the same model. They sure do love developing the same model over and over again. But in the highlights they simply call it CBT. Because it's basically like a book with blank pages, it does not matter what's in it, no one even cares. Only the cover, binding and the fact that it has pages made of paper.

Races to the bottom always lead you to the same outcome: the absolute bottom. They're still digging so they basically constantly redefine the bottom.