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Economic evaluation of brief cognitive behavioral therapy vs treatment as usual for suicidal soldiers

JAMA Psychiatry Dec 10, 2019

Bernecker SL, Zuromski KL, Curry JC, et al. - Researchers examined the cost-efficacy of brief cognitive-behavioral therapy vs treatment as usual for preventing suicidal behaviors among at-risk US Army soldiers. They conducted this economic evaluation using data from epidemiologic data sets and a clinical trial among suicidal soldiers conducted from January 31, 2011, to April 3, 2014. Treatment as usual alone vs treatment as usual plus 12 individual Brief cognitive behavioral therapy (BCBT)sessions were the implemented interventions. Treatment as usual included a range of pharmacologic and psychological treatment options. Outcomes suggest that for at-risk soldiers, the BCBT is probably a cost-effective intervention and should be considered for widespread implementation. The base-case analysis suggests that BCBT could avert nearly 23 to 25 more suicide attempts and 1 to 3 more suicide deaths per 100 patients treated than treatment as usual. Based on the federal discount rate, saving from $15,000 to $16,630 per patient is expected with BCBT vs treatment as usual. BCBT costs an additional $1,910 to $2250 per patient compared with treatment as usual in a worst-case scenario (ie, assuming the weakest plausible BCBT effect sizes).
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