Cost-effectiveness of cognitive behaviour therapy in addition to mebeverine for irritable bowel syndrome

Objectives Irritable bowel syndrome is often treated in primary-care settings, and it has a relatively large economic impact. Cognitive behaviour therapy (CBT) in addition to mebeverine has been shown to be effective in the short term, compared with treatment with mebeverine alone. This study assesses the impact that CBT in addition to mebeverine has on resource use, and its costeffectiveness. Methods Participants were recruited from general practices: those with ongoing symptoms were randomly allocated either to remain just on mebeverine or to receive CBT in addition to mebeverine. Service use and lost employment were measured at baseline and at the 3-month, 6-month and 12-month follow-ups. The net-benefit approach was used for combining the data on therapy costs and symptoms. Results The mean additional cost of CBT was 308 pound. No significant impact of CBT on the use of other services or on lost employment was noted. The cost per clinically important reduction in symptoms was 220 pound by the end of treatment, 171 pound at the 3-month follow-up, 21027 at the 6-month follow-up and 3080 pound at the 12-month follow-up, for CBT in addition to mebeverine compared with mebeverine alone. Conclusions CBT in addition to mebeverine seems to have reasonable cost-effectiveness in the short-term treatment of irritable bowel syndrome, but not beyond 3 months.