Psycho-educational CBT-Insomnia workshops in the community. A cost-effectiveness analysis alongside a randomised controlled trial

Behav Res Ther. 2014 Apr:55:40-7. doi: 10.1016/j.brat.2014.01.005. Epub 2014 Feb 6.

Abstract

Around one in three of the UK population suffer from sleep problems, resulting in high costs to society. Cognitive behaviour therapy for insomnia (CBT-I) has been shown to be effective. Community-based workshops may be a cost-effective way to provide CBT-I to groups that are usually hard to reach or reluctant to seek treatment. A sample of 151 participants aged 18 or over from five London boroughs who self-referred were randomised into a group receiving workshops and a waiting list control group. 111 provided complete data on service use and outcome measures. Results from the cost-effectiveness and cost-utility analyses are presented using cost-effectiveness acceptability curves. At a maximum willingness to pay per quality-adjusted life-year (QALY) of £30,000, the probability of the intervention being cost-effective is 80%. If commissioners are willing to pay £150 per point improvement on the Insomnia Severity Index, which is approximately the cost of the intervention, there is a 97% probability of cost-effectiveness. Community-based CBT-I workshops are likely to be a cost-effective intervention to improve insomnia symptoms and are a promising low-level option to include within the panoply of interventions that are encouraged within the UK policy of increasing access to psychological therapies.

Keywords: Cognitive behaviour therapy; Cost effectiveness; Costs and cost analysis; Group intervention; Insomnia; Self referral.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / economics*
  • Cost-Benefit Analysis*
  • Education / economics
  • Female
  • Health Care Costs
  • Humans
  • Male
  • Models, Economic
  • Patient Acceptance of Health Care
  • Patient Education as Topic / economics*
  • Residence Characteristics
  • Sleep Initiation and Maintenance Disorders / economics
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Young Adult