Mentalization-based treatment versus specialist treatment as usual for borderline personality disorder: Economic evaluation alongside a randomized controlled trial with 36-month follow-up

M. Blankers; D. Koppers; E.M.P. Laurenssen; J. Peen; M.L. Smits; P. Luyten; J. Busschbach; J.H. Kamphuis; M. Kikkert; J.J.M. Dekker

doi:10.1521/pedi_2019_33_454

Mentalization-based treatment versus specialist treatment as usual for borderline personality disorder: Economic evaluation alongside a randomized controlled trial with 36-month follow-up

M. Blankers, D. Koppers, E.M.P. Laurenssen, J. Peen, M.L. Smits, P. Luyten, J. Busschbach, J.H. Kamphuis, M. Kikkert, J.J.M. Dekker

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

The authors present an economic evaluation performed alongside a randomized controlled trial of mentalization-based treatment in a day hospital setting (MBT-DH) versus specialist treatment as usual (S-TAU) for borderline personality disorder (BPD) with a 36-month follow-up period. Ninety-five patients from two Dutch treatment institutes were randomly assigned. Societal costs were compared with the proportion of BPD remissions and quality-adjusted life years (QALYs) measured using the five-dimensional EuroQol instrument. The incremental societal costs for one additional QALY could not be calculated. The costs for one additional BPD remission with MBT-DH are approximately €29, 000. There was a 58% likelihood that MBT-DH leads to more remitted patients at additional costs compared with S-TAU, and a 35% likelihood that MBT-DH leads to more remissions at lower costs. MBT-DH is not cost-effective compared with S-TAU with QALYs as the outcome, and slightly more cost-effective than S-TAU at 36 months with BPD symptoms as the outcome.

Original language	English
Pages (from-to)	373-392
Number of pages	20
Journal	Journal of Personality Disorders
Volume	35
Issue number	3
Early online date	4 Nov 2019
DOIs	https://doi.org/10.1521/pedi_2019_33_454
Publication status	Published - Jun 2021

Funding

From Arkin Mental Health Care, Amsterdam, The Netherlands (M. B., D. K., J. P., M. K., J. J. M. D.); Trimbos-Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands (M. B.); Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (M. B.); Viersprong Institute for Studies on Personality Disorders, Bergen op Zoom, The Netherlands (E. M. P. L., M. L. S., J. B.); Faculty of Psychology and Educational Sciences, University of Leuven, Belgium (P. L.); Research Department of Clinical, Educational and Health Psychology, University College London, UK (P. L.); Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, The Netherlands (J. B.); Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands (J. J. M. D.);and Department of Psychology, University of Amsterdam, The Netherlands (J. H. K.). This research was supported in part by a grant from ZonMW, the Netherlands Organization for Health Research and Development (grant no. 171002402). Patrick Luyten has been involved in the training and dissemination of mentalization-based treatments. The other authors declare that they have no competing interests. We would like to thank Laura Bakker, Carolien Christ, and Isabel Alvarez Perez for their hard work in collecting the data. We are also very grateful to all the patients who participated in this study.

Funders	Funder number
Netherlands Organization for Health Research and Development	171002402
ZonMw

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Blankers, M., Koppers, D., Laurenssen, E. M. P., Peen, J., Smits, M. L., Luyten, P., Busschbach, J., Kamphuis, J. H., Kikkert, M., & Dekker, J. J. M. (2021). Mentalization-based treatment versus specialist treatment as usual for borderline personality disorder: Economic evaluation alongside a randomized controlled trial with 36-month follow-up. Journal of Personality Disorders, 35(3), 373-392. https://doi.org/10.1521/pedi_2019_33_454

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abstract = "The authors present an economic evaluation performed alongside a randomized controlled trial of mentalization-based treatment in a day hospital setting (MBT-DH) versus specialist treatment as usual (S-TAU) for borderline personality disorder (BPD) with a 36-month follow-up period. Ninety-five patients from two Dutch treatment institutes were randomly assigned. Societal costs were compared with the proportion of BPD remissions and quality-adjusted life years (QALYs) measured using the five-dimensional EuroQol instrument. The incremental societal costs for one additional QALY could not be calculated. The costs for one additional BPD remission with MBT-DH are approximately €29, 000. There was a 58% likelihood that MBT-DH leads to more remitted patients at additional costs compared with S-TAU, and a 35% likelihood that MBT-DH leads to more remissions at lower costs. MBT-DH is not cost-effective compared with S-TAU with QALYs as the outcome, and slightly more cost-effective than S-TAU at 36 months with BPD symptoms as the outcome.",

author = "M. Blankers and D. Koppers and E.M.P. Laurenssen and J. Peen and M.L. Smits and P. Luyten and J. Busschbach and J.H. Kamphuis and M. Kikkert and J.J.M. Dekker",

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Blankers, M, Koppers, D, Laurenssen, EMP, Peen, J, Smits, ML, Luyten, P, Busschbach, J, Kamphuis, JH, Kikkert, M & Dekker, JJM 2021, 'Mentalization-based treatment versus specialist treatment as usual for borderline personality disorder: Economic evaluation alongside a randomized controlled trial with 36-month follow-up', Journal of Personality Disorders, vol. 35, no. 3, pp. 373-392. https://doi.org/10.1521/pedi_2019_33_454

Mentalization-based treatment versus specialist treatment as usual for borderline personality disorder: Economic evaluation alongside a randomized controlled trial with 36-month follow-up. / Blankers, M.; Koppers, D.; Laurenssen, E.M.P. et al.
In: Journal of Personality Disorders, Vol. 35, No. 3, 06.2021, p. 373-392.

Research output: Contribution to Journal › Article › Academic › peer-review

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ER -

Mentalization-based treatment versus specialist treatment as usual for borderline personality disorder: Economic evaluation alongside a randomized controlled trial with 36-month follow-up

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