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
BackgroundAn 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....
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-11-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2022/11/e39248 |
| _version_ | 1827857894666665984 |
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| author | 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 |
| author_facet | 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 |
| author_sort | James Altunkaya |
| collection | DOAJ |
| description |
BackgroundAn 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.
ObjectiveIn 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.
MethodsUsing 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.
ResultsPatients 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.
ConclusionsgameChange 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 RegistrationISRCTN Registry ISRCTN17308399; https://www.isrctn.com/ISRCTN17308399
International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-031606 |
| first_indexed | 2024-03-12T12:46:54Z |
| format | Article |
| id | doaj.art-e5dbfaa6b8ef4e4aae4812c689abf62b |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:46:54Z |
| publishDate | 2022-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-e5dbfaa6b8ef4e4aae4812c689abf62b2023-08-28T23:18:25ZengJMIR PublicationsJournal of Medical Internet Research1438-88712022-11-012411e3924810.2196/39248Estimating the Economic Value of Automated Virtual Reality Cognitive Therapy for Treating Agoraphobic Avoidance in Patients With Psychosis: Findings From the gameChange Randomized Controlled Clinical TrialJames Altunkayahttps://orcid.org/0000-0002-8293-3466Michael Cravenhttps://orcid.org/0000-0001-5682-6360Sinéad Lambehttps://orcid.org/0000-0001-9543-8109Ariane Beckleyhttps://orcid.org/0000-0001-6026-9616Laina Rosebrockhttps://orcid.org/0000-0002-4583-8435Robert Dudleyhttps://orcid.org/0000-0002-3765-9998Kate Chapmanhttps://orcid.org/0000-0002-0232-4223Anthony Morrisonhttps://orcid.org/0000-0002-4389-2091Eileen O'Reganhttps://orcid.org/0000-0002-4819-3409Jenna Grabeyhttps://orcid.org/0000-0001-7498-1276Aislinn Berginhttps://orcid.org/0000-0002-4276-3466Thomas Kabirhttps://orcid.org/0000-0001-8908-0964Felicity Waitehttps://orcid.org/0000-0002-2749-1386Daniel Freemanhttps://orcid.org/0000-0002-2541-2197José Lealhttps://orcid.org/0000-0001-7870-6730 BackgroundAn 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. ObjectiveIn 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. MethodsUsing 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. ResultsPatients 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. ConclusionsgameChange 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 RegistrationISRCTN Registry ISRCTN17308399; https://www.isrctn.com/ISRCTN17308399 International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-031606https://www.jmir.org/2022/11/e39248 |
| spellingShingle | 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 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 Journal of Medical Internet Research |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://www.jmir.org/2022/11/e39248 |
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