Journal article
Estimating the economic value of automated virtual reality cognitive therapy for treating agoraphobic avoidance in patients with psychosis: findings from the gameChange Randomized Controlled Clinical Trial
- Abstract:
-
Background: An automated virtual reality cognitive therapy (gameChange) has demonstrated its effectiveness to treat agoraphobia in patients with psychosis, especially for high or severe anxious avoidance. Its economic value to the health care system is not yet established.
Objective: In this study, we aimed to estimate the potential economic value of gameChange for the UK National Health Service (NHS) and establish the maximum cost-effective price per patient.
Methods: Using data from a randomized controlled trial with 346 patients with psychosis (ISRCTN17308399), we estimated differences in health-related quality of life, health and social care costs, and wider societal costs for patients receiving virtual reality therapy in addition to treatment as usual compared with treatment as usual alone. The maximum cost-effective prices of gameChange were calculated based on UK cost-effectiveness thresholds. The sensitivity of the results to analytical assumptions was tested.
Results: Patients allocated to gameChange reported higher quality-adjusted life years (0.008 QALYs, 95% CI –0.010 to 0.026) and lower NHS and social care costs (–£105, 95% CI –£1135 to £924) compared with treatment as usual (£1=US $1.28); however, these differences were not statistically significant. gameChange was estimated to be worth up to £341 per patient from an NHS and social care (NHS and personal social services) perspective or £1967 per patient from a wider societal perspective. In patients with high or severe anxious avoidance, maximum cost-effective prices rose to £877 and £3073 per patient from an NHS and personal social services perspective and societal perspective, respectively.
Conclusions: gameChange is a promising, cost-effective intervention for the UK NHS and is particularly valuable for patients with high or severe anxious avoidance. This presents an opportunity to expand cost-effective psychological treatment coverage for a population with significant health needs.
Trial Registration: ISRCTN Registry ISRCTN17308399; https://www.isrctn.com/ISRCTN17308399
International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2019-031606
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 365.5KB, Terms of use)
-
- Publisher copy:
- 10.2196/39248
Authors
- Publisher:
- JMIR Publications
- Journal:
- Journal of Medical Internet Research More from this journal
- Volume:
- 24
- Issue:
- 11
- Article number:
- e39248
- Publication date:
- 2022-11-18
- Acceptance date:
- 2022-10-17
- DOI:
- EISSN:
-
1438-8871
- Language:
-
English
- Keywords:
- Pubs id:
-
1288110
- Local pid:
-
pubs:1288110
- Deposit date:
-
2022-10-31
Terms of use
- Copyright holder:
- Altunkaya et al
- Copyright date:
- 2022
- Rights statement:
- © James Altunkaya, Michael Craven, Sinéad Lambe, Ariane Beckley, Laina Rosebrock, Robert Dudley, Kate Chapman, Anthony Morrison, Eileen O'Regan, Jenna Grabey, Aislinn Bergin, Thomas Kabir, Felicity Waite, Daniel Freeman, José Leal. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 18.11.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
- Licence:
- CC Attribution (CC BY)
If you are the owner of this record, you can report an update to it here: Report update to this record