Chronisch Vermoeidheidssyndroom: diagnose, behandeling en ...

60 Chronic Fatigue Syndrome KCE reports 88
The treatment pattern for chronic fatigue patients was less intensive than for CFS
patients since only 6 sessions (of CBT, GET or CT) of 45-50 minutes each were
administered to chronic fatigue patients in McCrone et al. 141 and in Chisholm et al. 143
3.2.6 Unit costs of the therapeutic strategies
The original unit costs of the therapeutic strategies are reported in Table 8. To improve
the comparison between studies, original costs were standardized in common euros of
the year 2007 using Consumer Price Indices and Purchasing Power Parities (Table 7).
Table 7. Correction for price inflation and currency conversion
Author Publication Country Costing Original CPI PPP
year year currency multiplicator a multiplicator
Severens et al. 2004 Netherlands 1998 € 1,21653 1,00679
McCrone et al. 2004 UK 2001 £ 1,11166 1,35671
Chisholm et al. 2001 UK 1998 £ 1,14913 1,35671
a. From costing year to 2007; Consumer Price Indices (CPI) and Purchasing Power Parities (PPP) were
obtained from the OECD website, accessed on April the 24th 2008 (www.stats.oecd.org)
The cost of a CBT session greatly differed according to the population targeted in the
studies. In Severens et al., 142 a 60-minutes CBT session delivered to CFS patients costs
€114 (Table 8), while in McCrone et al. 141 and in Chisholm et al., 143 a 45-50-minutes
CBT session delivered to chronic fatigue patients is worth about the half (€50).
In the three economic evaluations, the unit costs for CBT cover the actual time spent
by the therapist (for patients-based or administrative activities) and his training. Beside
this, the unit costs for CBT in Severens et al. 142 also cover an extensive diagnostic
procedure to identify CFS patients eligible to this form of therapy. Without those
diagnostic costs, the unit costs of CBT for CFS patients (€83 per session) still remain
higher than those for chronic fatigue patients. f
Table 8. Cost per CBT, SG, GET and CT session
Author Publication Country CBT Original cost per session Cost in 2007 Belgian €
year Intensity CBT SG GET CT CBT SG GET CT
Severens et al. a
2004 Netherlands 16 x 60 min €93,1 €38,5 - - €114,1 €47,2 - -
McCrone et al. 2004 UK 6 x 45 min £30,0 - £30,8 - €45,2 - €46,4 -
Chisholm et al. 2001 UK 6 x 50 min £33,3 - - £23,3 €52,0 - - €36,4
a. In Severens et al., the additional cost of extensive diagnostic activities is shared out in the cost of aCBTsession.
Without those diagnostic costs, the cost of a CBT session becomes €82,6 (cost in 2007 €); CBT: cognitive behaviour
therapy; SG: guided support group; GET graded exercise therapy; CT: counselling therapy
The unit costs for other therapies appeared to be relatively similar (Table 8). With the
exception of McCrone et al., 141 a CBT session is estimated to be more expensive than
its comparators.
3.3 RESULTS OF THE ECONOMIC EVALUATIONS
3.3.1 Incremental costs
A breakdown of the mean costs per patient for each therapy considered is presented in
Table 9, together with the incremental costs of CBT over its comparators.
f The higher unit cost of a CBT session in The Netherlands, even after deduction of the diagnostic costs,
may be due to the fact that CBT was administered in the outpatient department of a university hospital in
this country, whereas it was administered in community care in The UK.