Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder
Background There are few economic evaluations of adjunctive psychosocial therapies for bipolar disorder. Aims Estimate the cost–utility of in-person psychosocial therapies for adults with bipolar disorder added to treatment as usual (TAU), from an Australian Government perspective. Method We d...
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Cambridge University Press
2025-07-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472425100689/type/journal_article |
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| author | Mary Lou Chatterton Yong Yi Lee Long Khanh-Dao Le Melanie Nichols Michael Berk Cathrine Mihalopoulos |
| author_facet | Mary Lou Chatterton Yong Yi Lee Long Khanh-Dao Le Melanie Nichols Michael Berk Cathrine Mihalopoulos |
| author_sort | Mary Lou Chatterton |
| collection | DOAJ |
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Background
There are few economic evaluations of adjunctive psychosocial therapies for bipolar disorder.
Aims
Estimate the cost–utility of in-person psychosocial therapies for adults with bipolar disorder added to treatment as usual (TAU), from an Australian Government perspective.
Method
We developed an economic model, estimating costs in 2021 Australian dollars (A$) and outcomes using quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted. The model compared psychoeducation, brief psychoeducation, carer psychoeducation, cognitive–behavioural therapy (CBT) and family therapy when added to TAU (i.e. pharmacotherapy) over a year for adults (18–65 years) with bipolar disorder. The relative risk of relapse was sourced from two network meta-analyses and applied to the depressive phase in the base case. Probabilistic sensitivity analysis and one-way sensitivity analyses were conducted, assessing robustness of results.
Results
Carer psychoeducation was preferred in the base case when the willingness-to-pay (WTP) threshold is below A$1000 per QALY gained and A$1500 per DALY averted. Brief psychoeducation was preferred when WTP is between A$1000 and A$300 000 per QALY gained and A$1500 and A$450 000 per DALY averted. Family therapy was only preferred at WTP thresholds above A$300 000 per QALY gained or A$450 000 per DALY averted. In sensitivity analyses, brief psychoeducation was the preferred therapy. Psychoeducation and CBT were dominated (more costly and less effective) in base-case and sensitivity analyses.
Conclusions
Carer and brief psychoeducation were found to be the most cost-effective psychosocial therapies, supporting use as adjunctive treatments for adults with bipolar disorder and their families in Australia.
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| format | Article |
| id | doaj-art-2eeb31fb1f304582bd6a67ba35a71490 |
| institution | DOAJ |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-2eeb31fb1f304582bd6a67ba35a714902025-08-20T02:40:35ZengCambridge University PressBJPsych Open2056-47242025-07-011110.1192/bjo.2025.10068Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorderMary Lou Chatterton0https://orcid.org/0000-0003-4902-9448Yong Yi Lee1Long Khanh-Dao Le2https://orcid.org/0000-0002-9442-6824Melanie Nichols3Michael Berk4https://orcid.org/0000-0002-5554-6946Cathrine Mihalopoulos5School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia Institute for Health Transformation, Deakin University, Geelong, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia School of Public Health, The University of Queensland, Herston, Australia Queensland Centre for Mental Health Research, Brisbane, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, AustraliaInstitute for Health Transformation, Deakin University, Geelong, AustraliaInstitute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Australia Institute for Health Transformation, Deakin University, Geelong, Australia Background There are few economic evaluations of adjunctive psychosocial therapies for bipolar disorder. Aims Estimate the cost–utility of in-person psychosocial therapies for adults with bipolar disorder added to treatment as usual (TAU), from an Australian Government perspective. Method We developed an economic model, estimating costs in 2021 Australian dollars (A$) and outcomes using quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted. The model compared psychoeducation, brief psychoeducation, carer psychoeducation, cognitive–behavioural therapy (CBT) and family therapy when added to TAU (i.e. pharmacotherapy) over a year for adults (18–65 years) with bipolar disorder. The relative risk of relapse was sourced from two network meta-analyses and applied to the depressive phase in the base case. Probabilistic sensitivity analysis and one-way sensitivity analyses were conducted, assessing robustness of results. Results Carer psychoeducation was preferred in the base case when the willingness-to-pay (WTP) threshold is below A$1000 per QALY gained and A$1500 per DALY averted. Brief psychoeducation was preferred when WTP is between A$1000 and A$300 000 per QALY gained and A$1500 and A$450 000 per DALY averted. Family therapy was only preferred at WTP thresholds above A$300 000 per QALY gained or A$450 000 per DALY averted. In sensitivity analyses, brief psychoeducation was the preferred therapy. Psychoeducation and CBT were dominated (more costly and less effective) in base-case and sensitivity analyses. Conclusions Carer and brief psychoeducation were found to be the most cost-effective psychosocial therapies, supporting use as adjunctive treatments for adults with bipolar disorder and their families in Australia. https://www.cambridge.org/core/product/identifier/S2056472425100689/type/journal_articleBipolar disordercost-utility analysispsychosocial therapymaniadepression |
| spellingShingle | Mary Lou Chatterton Yong Yi Lee Long Khanh-Dao Le Melanie Nichols Michael Berk Cathrine Mihalopoulos Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder BJPsych Open Bipolar disorder cost-utility analysis psychosocial therapy mania depression |
| title | Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder |
| title_full | Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder |
| title_fullStr | Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder |
| title_full_unstemmed | Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder |
| title_short | Cost–utility analysis of adjunctive psychosocial therapies in bipolar disorder |
| title_sort | cost utility analysis of adjunctive psychosocial therapies in bipolar disorder |
| topic | Bipolar disorder cost-utility analysis psychosocial therapy mania depression |
| url | https://www.cambridge.org/core/product/identifier/S2056472425100689/type/journal_article |
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