Cited by 48Health Systems, Economic Evaluations, Quality of LifeAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Preventing panic disorder: cost-effectiveness analysis alongside a pragmatic randomised trial

Open access
Smit, Filip, Willemse, Godelief, Meulenbeek, Peter, Koopmanschap, Marc, van Balkom, Anton, Spinhoven, Philip, Cuijpers, Pim·2009·Cost Effectiveness and Resource Allocation

Abstract

BACKGROUND: Panic disorder affects many people, is associated with a formidable disease burden, and imposes costs on society. The annual influx of new cases of panic disorder is substantial. From the public health perspective it may therefore be a sound policy to reduce the influx of new cases, to maintain the quality of life in many people, and to avoid the economic costs associated with the full-blown disorder. For this purpose, prevention is needed. Here we present the first economic evaluation of such an intervention. METHODS: Randomised trial of 117 people with panic disorder symptoms not meeting the diagnostic criteria of DSM-IV panic disorder. The interventions were time-limited cognitive-behavioural therapy v care-as-usual. The central clinical endpoint was DSM-IV panic disorder-free survival over 3 months. Costs were calculated from the societal perspective. Using the bootstrap method, incremental cost-effectiveness ratios were obtained, placed in 95% confidence intervals, projected on the cost-effectiveness plane, and presented as acceptability curves. RESULTS: The median incremental cost-effectiveness ratio is euro6,198 (95% CI 2,435 - 60,731) per PD-free survival gained, which has a likelihood of 75.2% of being more acceptable from a cost-effectiveness point of view than care-as-usual when a willingness-to-pay ceiling is assumed of euro10,000 per PD-free survival. The most significant cost driver was therapists' time. A sensitivity analysis indicated that cost-effectiveness improves when the number of therapist hours is reduced. CONCLUSION: This is the first economic evaluation alongside a prevention trial in panic disorder. The small sample (n = 117) and the short time horizon of 3 months preclude firm conclusions, but our findings suggest that the intervention may be acceptable from a cost-effectiveness point of view, especially when therapist involvement can be kept minimal. Nevertheless, our results must await replication in a larger trial with longer follow-up times before we can confidently recommend implementation of the intervention on a broad scale. In the light of our findings and given the burden of panic disorder, such a new trial is well worth the effort.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/1478-7547-7-8

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • An economic evaluation of the intervention for a subgroup of the sample (people with subthreshold panic disorder) showed that it may be acceptable from a cost-effectiveness point of view.

    “An economic evaluation of the intervention for a subgroup of the sample (i.e. people with subthreshold panic disorder) showed that it may be acceptable from a cost-effectiveness point of view. 34”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Smit, F., Willemse, G., Meulenbeek, P., Koopmanschap, M., van Balkom, A., Spinhoven, P., & Cuijpers, P.
Affiliations
  • Trimbos Institute (NL)
  • GGNet (NL)
  • Erasmus MC (NL)
  • Leiden University Medical Center (NL)
  • Amsterdam Public Health (NL)
Corresponding author
Smit, Filip
Venue
Cost Effectiveness and Resource Allocation
Published
2009
Volume
7
Issue
1
Pages
8
ISSN
1478-7547 (ISSN-L)
OpenAlex
W2100530006
Cited by
48
References
37
Citations by year
2025: 1 · 2024: 2 · 2023: 1 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 6 · 2013: 6 · 2012: 5
FWCI
11.98
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Cost Effectiveness and Resource Allocation (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (acceptedVersion)
  • VU Research Portal (acceptedVersion, other-oa)
  • Pure Amsterdam UMC (submittedVersion)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • RePub (Erasmus University Rotterdam) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
  • ZonMw
  • Trimbos-instituut
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
panic disorder, prevention, cost-effectiveness, cognitive behavioral therapy, time-limited therapy, social costs, acceptability curves, willingness to pay

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review