{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:48:18Z","timestamp":1753883298151,"version":"3.41.2"},"reference-count":33,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute for Health Research, Research for Patient Benefit Funding Stream","award":["PB-PG-1208-18024"],"award-info":[{"award-number":["PB-PG-1208-18024"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["MDM Policy &amp; Practice"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:p> Background: There is a growing interest in using group cognitive\u2013behavioral therapy (CBT) with people who have Asperger syndrome (AS) and comorbid mental health problems. This study aims to assess the cost-effectiveness of modified group CBT for adults with AS experiencing co-occurring anxiety compared to treatment-as-usual. Methods: Economic evaluation alongside a pilot, multicenter, single-blind, randomized controlled crossover trial. Costs from the UK public sector (National Health Service and Social Services) and societal perspectives, quality-adjusted life years (QALYs), incremental net (monetary) benefit (INB), expected value of perfect information, expected value of sample information, expected net gain of sampling, and efficient sample size of a future trial are reported. Results: Over 48 weeks, from the societal perspective, CBT results in additional costs of \u00a36,647, with only a 0.015 incremental gain in QALYs, leading to a negative INB estimate of \u00a36,206 and a 23% probability of cost-effectiveness at a threshold of \u00a330,000\/QALY. Results from sensitivity analyses support the unlikely cost-effectiveness of CBT but indicate the potential for cost-effectiveness over longer time horizons. Eliminating decision uncertainty is valued at \u00a3277 million, and the efficient sample size for a future trial is estimated at 1,200 participants per arm. Limitations: Relatively small sample size and prevalence of missing data present challenges to the interpretation of the results. Conclusions: Current evidence from this small pilot study suggests that, on average, modified group CBT is not cost-effective. However, there is much decision uncertainty so such a conclusion could be wrong. A large, full-scale trial to reduce uncertainty would be an efficient investment for the UK health economy. <\/jats:p>","DOI":"10.1177\/2381468317729353","type":"journal-article","created":{"date-parts":[[2017,8,31]],"date-time":"2017-08-31T06:51:46Z","timestamp":1504162306000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Economic Evaluation Alongside a Randomized Controlled Crossover Trial of Modified Group Cognitive\u2013Behavioral Therapy for Anxiety Compared to Treatment-as-Usual in Adults With Asperger Syndrome"],"prefix":"10.1177","volume":"2","author":[{"given":"Brett","family":"Doble","sequence":"first","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter E.","family":"Langdon","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Shepstone","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glynis H.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fowler","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Heavens","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida","family":"Malovic","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health 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of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Rose","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK (BD, ECFW)"},{"name":"Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK (BD)"},{"name":"Tizard Centre, University of Kent, Canterbury, UK (PEL, GHM, AM)"},{"name":"Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norwich, UK (PEL, LM)"},{"name":"Department of Population Health and Primary Care (LS, ECFW), Norwich Medical School, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Mullineaux","sequence":"additional","affiliation":[{"name":"Cambridge Centre for Health Services Research, University of 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