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BACKGROUND: The cost effectiveness of various treatment strategies for bulimia nervosa (BN) is unknown. AIMS: To examine the cost effectiveness of stepped care treatment for BN. METHOD: Randomized trial conducted at four clinical centers with intensive measurement of direct medical costs and repeated measurement of subject quality of life and family/significant other time involvement. Two hundred ninety-three women who met DSM-IV criteria for BN received stepped care treatment or cognitive behavioral therapy. Cost effectiveness ratios were compared. RESULTS: The cost per abstinent subject was $12,146 for stepped care, and $20,317 for cognitive behavioral therapy. Quality of life ratings improved significantly with treatment, and family/significant other time burden diminished substantially. DISCUSSION: In this trial, stepped care for BN appeared cost effective in comparison to cognitive behavioral therapy. Treatment was associated with improved quality of life and diminished time costs of illness.

Original publication

DOI

10.1002/eat.22087

Type

Journal article

Journal

Int J Eat Disord

Publication Date

05/2013

Volume

46

Pages

302 - 307

Keywords

Adult, Bulimia Nervosa, Cognitive Therapy, Combined Modality Therapy, Cost-Benefit Analysis, Female, Fluoxetine, Humans, Serotonin Uptake Inhibitors, Treatment Outcome