Cost-Effectiveness of Transdiagnostic Group Cognitive Behavioral Therapy for Emotional Disorders in Primary Care: An Analysis of the PsicAP Clinical Trial

Objective/s: Transdiagnostic cognitive behavioral therapy has proven to be an effective treatment for emotional disorders. However, the cost-effectiveness of group transdiagnostic cognitive behavioral therapy remains unknown. Given the growing demand for psychological care in primary care in the context of limited resources, an economic evaluation of transdiagnostic group cognitive behavioral therapy (TD-GCBT) would provide valuable data for treatment decision making. Aims: To conduct an economic evaluation of the PsicAP treatment protocol. Method: The PsicAP-Costs was a multicenter, randomized controlled trial of 429 patients with a suspected diagnosis of anxiety, depression, and/or somatoform disorders. Participants were randomized to treatment as usual (TAU [control group]) or TD-GCBT plus TAU (experimental group). Treatment consisted of seven sessions of TD-GCBT delivered over a 12-14 week period. Results: The primary efficacy outcomes were significantly better in the TD-GCBT + TAU group, with small to large effect sizes for the reduction of depression, anxiety, and somatization symptoms. The economic evaluation yielded a mean incremental effectiveness of 0.06 quality-adjusted life years with a mean incremental cost of ¿263. This resulted in an incremental cost-effectiveness ratio of ¿4,759 per quality-adjusted life year. Conclusions: The integration of TD-GCBT into TAU represents a cost-effective therapeutic approach. The incremental cost-effectiveness ratio of ¿4,759 per quality-adjusted life year is well below the willingness-to-pay threshold accepted in Spain, which ranges from ¿20,000 to ¿25,000. At this threshold, the probability that the intervention is cost-effective is high, ranging from 86% to 89%. Therefore, the implementation of TD-GCBT in primary care may represent a cost-effective option for improving the quality of care for emotional disorders.