# Health Economic Evaluation of Cognitive‐Behavioral Therapy for Adolescents With Binge‐Eating Disorder in Germany

## TL;DR

This study evaluates whether cognitive-behavioral therapy is cost-effective for treating binge-eating disorder in German adolescents compared to a waitlist.

## Contribution

The study provides new health economic evidence on CBT for binge-eating disorder in adolescents using a randomized controlled trial.

## Key findings

- CBT resulted in 4.7 more binge-free episodes compared to the waitlist group.
- The ICER for a binge-free episode was €46.70, and for a QALY gained was €128,861.
- CBT showed a >95% probability of cost-effectiveness for binge-free episodes at €101 willingness-to-pay.

## Abstract

To determine the cost‐effectiveness of cognitive‐behavioral therapy (CBT) for adolescents with binge‐eating disorder (BED), focusing on the costs per binge‐free episode and per quality‐adjusted life year (QALY) gained in comparison to a waitlist (WL) control group.

In the prospective, randomized superiority Binge‐Eating Disorder in Adolescents (BEDA) trial, evaluating the efficacy of CBT with 20 individual sessions over 4 months versus WL, clinical and cost data were assessed at baseline and after 4 months. Missing values were imputed using multiple imputation techniques. The incremental cost‐effectiveness ratio (ICER) was calculated. To reflect uncertainty, nonparametric bootstrapping was performed, and the results were presented in the form of cost‐effectiveness acceptability curves (CEACs).

The study population consisted of 73 adolescents (82.2% female, mean age: 15.5 ± 2.6 years). Participants receiving CBT (n = 37) exhibited 4.7 more binge‐free episodes (p = 0.0056) than the WL group (n = 36). The ICER was €46.70 for the gain of a binge‐free episode and €128,861 for the gain of a QALY.

The probability of cost‐effectiveness for achieving a binge‐free episode is > 95% at a willingness‐to‐pay of €101. In terms of QALYs, CBT for BED may be a cost‐effective intervention. A longer follow‐up period may have yielded more favorable cost‐effectiveness results.

German Clinical Trials Register, https://www.drks.de, DRKS00000542