Objectives: Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy. Methods: Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Results: Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICERthat is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapywas estimated at 52,384 per QALY gained. Conclusions: Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

Cost-effectiveness, Cost-utility, Long-term, Psychoanalysis, Psychoanalytic psychotherapy
dx.doi.org/10.1017/S0266462309990791, hdl.handle.net/1765/33045
International Journal of Technology Assessment in Health Care
Erasmus MC: University Medical Center Rotterdam

Berghout, C.C, Zevalkink, J, & Hakkaart-van Roijen, L. (2010). A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy. International Journal of Technology Assessment in Health Care, 26(1), 3–10. doi:10.1017/S0266462309990791