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Economics
Collaborative care involving pharmacotherapy was cost effective for increasing anxiety free days in panic disorder

https://doi.org/10.1136/ebm.8.4.126

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    (2002) Arch Gen Psychiatry 59, 1098. Katon WJ, Roy-Byrne P, Russo J, et al.. Cost-effectiveness and cost offset of a collaborative care intervention for primary care patients with panic disorder.. ;. :. –104.
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 QUESTION: In primary care patients with panic disorder, is collaborative care (CC) involving pharmacotherapy more cost effective than usual care (UC) for increasing anxiety free days?

    Design

    Cost effectiveness analysis (from a payer or plan perspective) based on a randomised {allocation concealed*}†, blinded (outcome assessors)*, controlled trial with 12 months of follow up.

    Setting

    3 primary care clinics in Seattle, Washington, USA.

    Patients

    115 patients who were 18–65 years of age (mean age 41 y, 57% women), met DSM–IV criteria for panic disorder with ≥1 panic attack in the past month, spoke English, and had a telephone. Exclusion criteria were current psychiatric treatment or disability benefit claims. Follow up was 94%.

    Intervention

    Patients were allocated to a multifaceted CC intervention (n=57) or UC (n=58). The CC intervention consisted of an initial psychiatric visit at which paroxetine was prescribed (10 mg/d to start, with increases to a …

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    Footnotes

    • Sources of funding: Smith-Kline-Beecham and National Institute of Mental Health Services Divison.

    • For correspondence: Dr W J Katon, University of Washington Medical School, Seattle, WA, USA.wkaton{at}u.washington.edu

    • ↵* See glossary.

    • ↵† Information provided by author.