Cost-effectiveness of relapse-prevention cognitive therapy for bipolar disorder: 30-month study.

BACKGROUND We have reported the advantageous clinical outcome of adding cognitive therapy to medication in the prevention of relapse of bipolar disorder. AIMS This 30-month study compares the cost-effectiveness of cognitive therapy with standard care. METHOD We randomly allocated 103 individuals with bipolar 1 disorder to standard treatment and cognitive therapy plus standard treatment. Service use and costs were measured at 3-month intervals and cost-effectiveness was assessed using the net-benefit approach. RESULTS The group receiving cognitive therapy had significantly better clinical outcomes. The extra costs were offset by reduced service use elsewhere. The probability of cognitive therapy being cost-effective was high and robust to different therapy prices. CONCLUSIONS Combination of cognitive therapy and mood stabilizers was superior to mood stabilizers alone in terms of clinical outcome and cost-effectiveness for those with frequent relapses of bipolar disorder.