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

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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?


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.


3 primary care clinics in Seattle, Washington, USA.


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%.


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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  • 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}

  • * See glossary.

  • Information provided by author.