Cost-effectiveness of cognitive behavioural therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury.
Duncan Mortimer, Lucy Ymer, Adam McKay and 8 others
PMID 40275692WHAT IT FOUND
Cognitive behavioural therapy for sleep and fatigue after brain injury costs about A$2,767 per person.
It is likely cost-effective compared to health education, with savings in other health services offsetting the delivery cost for most participants.
Key findings
01The average total direct and indirect cost of delivering the CBT-SF intervention was A$2,767 per participant.
02CBT-SF was likely cost-effective compared to Health Education, with the probability of being cost-effective ranging from 66% to 77% at a threshold of A$200.
03The study did not compare costs directly against usual care alone, so the true additional cost of CBT-SF over standard practice is uncertain.
STILL TO COME
How it was doneWhat they found
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The economic evaluation compared CBT-SF against an active control (Health Education), not usual care alone. This means the study does not clarify the incremental cost of CBT-SF over standard practice, which would likely be higher. Costs are specific to the Australian health system and 2023/24 prices, limiting generalizability to other countries or healthcare funding models. The trial period included COVID-19 restrictions, leading to a high proportion of telehealth delivery (76-78%), which may not reflect typical face-to-face service costs. The study pooled participants with stroke and traumatic brain injury, so it does not distinguish cost-effectiveness for either condition individually.
Declared interests
The authors declared no conflicts of interest. The work was partly supported by the National Health and Medical Research Council.
The easy way to misread this
Do not assume this study proves CBT-SF is cheaper than standard care. It only shows CBT-SF is likely cost-effective compared to another active intervention (Health Education). The cost of delivering CBT-SF over usual care remains uncertain and is likely higher than the A$333 difference reported between the two trial arms.