A cost effectiveness analysis of stepped care treatment for bulimia nervosa

Int J Eat Disord. 2013 May;46(4):302-7. doi: 10.1002/eat.22087. Epub 2013 Jan 28.

Abstract

Background: The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown.

Aims: To examine the cost effectiveness of stepped care treatment for BN.

Method: Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behavioral therapy. Cost effectiveness ratios were compared.

Results: The cost per abstinent subject was $12,146 for stepped care, and $20,317 for cognitive behavioral therapy. Quality of life ratings improved significantly with treatment, and family/significant other time burden diminished substantially.

Discussion: In this trial, stepped care for BN appeared cost effective in comparison to cognitive behavioral therapy. Treatment was associated with improved quality of life and diminished time costs of illness.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bulimia Nervosa / drug therapy
  • Bulimia Nervosa / economics
  • Bulimia Nervosa / psychology
  • Bulimia Nervosa / therapy*
  • Cognitive Behavioral Therapy / economics*
  • Combined Modality Therapy / economics
  • Cost-Benefit Analysis
  • Female
  • Fluoxetine / economics
  • Fluoxetine / therapeutic use*
  • Humans
  • Selective Serotonin Reuptake Inhibitors / economics
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors
  • Fluoxetine