Economic evaluation of a randomised controlled trial for anorexia nervosa in adolescents

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Abstract
Background: Young people with anorexia nervosa are often admitted to hospital for treatment. As well as being disruptive to school, family and social life, in-patient treatment is expensive, yet cost-effectiveness evidence is lacking.Aims: Cost-effectiveness analysis of three treatment strategies for adolescents with anorexia nervosa.Method: UK multicentre randomised, controlled trial comparing in-patient psychiatric treatment, specialist out-patient treatment and general out-patient treatment. Outcomes and costs assessed at baseline, 1 and 2 years.Results: There were 167 young people in the trial. There were no statistically significant differences in clinical outcome between the three groups at 2 years. The specialist out-patient group was less costly over the 2-year follow-up (mean total cost £26 738) than the in-patient (£34 531) and general out-patient treatment (£40 794) groups, but this result was not statistically significant. Exploration of the uncertainty associated with the costs and effects of the three treatments suggests that specialist out-patient treatment has the highest probability of being cost-effective.Conclusions: On the basis of cost-effectiveness, these results support the provision of specialist out-patient services for adolescents with anorexia nervosa.