Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents

Sarah Byford, Barbara Barrett, Chris Roberts, Andrew Clark, Vanessa Edwards, Nicola Smethurst, Simon G Gowers
British Journal of Psychiatry 2007, 191: 436-40

BACKGROUND: Young people with anorexia nervosa are often admitted to hospital for treatment. As well as being disruptive to school, family and social life, in-patient treatment is expensive, yet cost-effectiveness evidence is lacking.

AIMS: Cost-effectiveness analysis of three treatment strategies for adolescents with anorexia nervosa.

METHOD: UK multicentre randomised, controlled trial comparing in-patient psychiatric treatment, specialist out-patient treatment and general out-patient treatment. Outcomes and costs assessed at baseline, 1 and 2 years.

RESULTS: There were 167 young people in the trial. There were no statistically significant differences in clinical outcome between the three groups at 2 years. The specialist out-patient group was less costly over the 2-year follow-up (mean total cost 26 738 UK pounds) than the in-patient (34 531 UK pounds) and general out-patient treatment (40 794 UK pounds) groups, but this result was not statistically significant. Exploration of the uncertainty associated with the costs and effects of the three treatments suggests that specialist out-patient treatment has the highest probability of being cost-effective.

CONCLUSIONS: On the basis of cost-effectiveness, these results support the provision of specialist out-patient services for adolescents with anorexia nervosa.

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