{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:13:09Z","timestamp":1783660389036,"version":"3.55.0"},"reference-count":34,"publisher":"JMIR Publications Inc.","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An automated virtual reality cognitive therapy (gameChange) has demonstrated its effectiveness to treat agoraphobia in patients with psychosis, especially for high or severe anxious avoidance. Its economic value to the health care system is not yet established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this study, we aimed to estimate the potential economic value of gameChange for the UK National Health Service (NHS) and establish the maximum cost-effective price per patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from a randomized controlled trial with 346 patients with psychosis (ISRCTN17308399), we estimated differences in health-related quality of life, health and social care costs, and wider societal costs for patients receiving virtual reality therapy in addition to treatment as usual compared with treatment as usual alone. The maximum cost-effective prices of gameChange were calculated based on UK cost-effectiveness thresholds. The sensitivity of the results to analytical assumptions was tested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients allocated to gameChange reported higher quality-adjusted life years (0.008 QALYs, 95% CI \u20130.010 to 0.026) and lower NHS and social care costs (\u2013\u00a3105, 95% CI \u2013\u00a31135 to \u00a3924) compared with treatment as usual (\u00a31=US $1.28); however, these differences were not statistically significant. gameChange was estimated to be worth up to \u00a3341 per patient from an NHS and social care (NHS and personal social services) perspective or \u00a31967 per patient from a wider societal perspective. In patients with high or severe anxious avoidance, maximum cost-effective prices rose to \u00a3877 and \u00a33073 per patient from an NHS and personal social services perspective and societal perspective, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>gameChange is a promising, cost-effective intervention for the UK NHS and is particularly valuable for patients with high or severe anxious avoidance. This presents an opportunity to expand cost-effective psychological treatment coverage for a population with significant health needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ISRCTN Registry ISRCTN17308399; https:\/\/www.isrctn.com\/ISRCTN17308399<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>International Registered Report Identifier (IRRID)<\/jats:title>\n                    <jats:p>RR2-10.1136\/bmjopen-2019-031606<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/39248","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T10:45:26Z","timestamp":1668768326000},"page":"e39248","source":"Crossref","is-referenced-by-count":21,"title":["Estimating the Economic Value of Automated Virtual Reality Cognitive Therapy for Treating Agoraphobic Avoidance in Patients With Psychosis: Findings From the gameChange Randomized Controlled Clinical 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