Befriending carers of people with dementia: a cost utility analysis

Objective There is very little evidence on the cost effectiveness of social care interventions for people with dementia or their carers. The BEfriending and Costs of CAring trial (BECCA, ISRCTN08130075) aimed to establish whether a structured befriending service improved the quality of life of carers of people with dementia, and at what cost. Methods We performed an economic evaluation alongside a single blind, randomised controlled trial in a community setting of 236 carers of people with a primary progressive dementia. The intervention was contact with a Befriender Facilitator (BF), and offer of match with a trained lay volunteer befriender compared with no BF contact. Main outcome measures were health and social care, voluntary sector, and family care costs and quality adjusted life years (QALYs) in carers over 15 months. Results Mean QALYs per carer over 15 months were 0.017 higher in the intervention group compared with control (95%CI: -0.051, 0.083). Mean costs from a societal perspective were 1,813 pound higher (-11,312 pound, 14,984) pound. The point estimate Incremental Cost Effectiveness Ratio (ICER) is thus 105,954 pound per incremental QALY gained. Probabilistic sensitivity analysis suggests a 42.2% probability that the ICER is below 30,000 pound per QALY. Inclusion of dementia patient QALYs reduces the ICER to 28,848 pound (51.4% probability below 30,000) pound. Conclusions Befriending leads to a non-significant trend towards improved carer quality of life, and there is a non-significant trend towards higher costs for all sectors. It is unlikely that befriending is a cost-effective intervention from the point of view of society. Copyright (C) 2008 John Wiley & Sons, Ltd.