Health Economic Evaluation of Cognitive‐Behavioral Therapy for Adolescents With Binge‐Eating Disorder in Germany

• DOI: 10.1002/eat.24413
• Publication Date: 2025-03-12T05:13:08Z
• Authors: Nicolas Pardey; Ricarda Schmidt; Jan Zeidler; Anja Hilbert

ABSTRACTObjectiveTo determine the cost‐effectiveness of cognitive‐behavioral therapy (CBT) for adolescents with binge‐eating disorder (BED), focusing on the costs per binge‐free episode and per quality‐adjusted life year (QALY) gained in comparison to a waitlist (WL) control group.MethodIn the prospective, randomized superiority Binge‐Eating Disorder in Adolescents (BEDA) trial, evaluating the efficacy of CBT with 20 individual sessions over 4 months versus WL, clinical and cost data were assessed at baseline and after 4 months. Missing values were imputed using multiple imputation techniques. The incremental cost‐effectiveness ratio (ICER) was calculated. To reflect uncertainty, nonparametric bootstrapping was performed, and the results were presented in the form of cost‐effectiveness acceptability curves (CEACs).ResultsThe study population consisted of 73 adolescents (82.2% female, mean age: 15.5 ± 2.6 years). Participants receiving CBT (n = 37) exhibited 4.7 more binge‐free episodes (p = 0.0056) than the WL group (n = 36). The ICER was €46.70 for the gain of a binge‐free episode and €128,861 for the gain of a QALY.DiscussionThe probability of cost‐effectiveness for achieving a binge‐free episode is > 95% at a willingness‐to‐pay of €101. In terms of QALYs, CBT for BED may be a cost‐effective intervention. A longer follow‐up period may have yielded more favorable cost‐effectiveness results.Trial RegistrationGerman Clinical Trials Register, https://www.drks.de, DRKS00000542