Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults

This guideline was developed by an independent multi-disciplinary group of clinical academics, health professionals and service users, and care representatives with expertise and experience in the field of PTSD. The guideline informed the updating of national guidance for the management of PTSD in England, published by the National Institute for Health and Care Excellence (NICE). A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective among them.

Article Abstract

“Background: Post-traumatic stress disorder (PTSD) is a severe and disabling condition that may lead to functional impairment and reduced productivity. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost-effectiveness of a range of interventions for adults with PTSD.

Methods: A decision-analytic model was constructed to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment for adults with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta-analysis. Other model input parameters were based on published sources, supplemented by expert opinion.

Results: Eye movement desensitisation and reprocessing (EMDR) appeared to be the most cost-effective intervention for adults with PTSD (with a probability of 0.34 amongst the 11 evaluated options at a cost-effectiveness threshold of £20,000/QALY), followed by combined somatic/cognitive therapies, self-help with support, psychoeducation, selective serotonin reuptake inhibitors (SSRIs), trauma-focused cognitive behavioural therapy (TF-CBT), self-help without support, non-TF-CBT and combined TF-CBT/SSRIs. Counselling appeared to be less cost-effective than no treatment. TF-CBT had the largest evidence base.

Conclusions: A number of interventions appear to be cost-effective for the management of PTSD in adults. EMDR appears to be the most cost-effective amongst them. TF-CBT has the largest evidence base. There remains a need for well-conducted studies that examine the long-term clinical and cost-effectiveness of a range of treatments for adults with PTSD.”

—Description from publisher

Article Access

Open Access 

Mavranezouli, I., Megnin-Viggars, O., Grey, N., Bhutani, G., Leach, J. Daly, C., Dias, S., Welton, N. J., Katona, C., El-Leithy, S., Greenberg, N., Stockton, S., & Pilling, S. (2020). Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults. PLoS ONE 15(4): e0232245. Open access: https://doi.org/10.1371/journal.pone.0232245

About the Journal

“PLoS ONE is an inclusive journal community working together to advance science by making all rigorous research accessible without barriers.”

—Description from publisher