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COST-UTILITY OF SELF-MANAGED COMPUTER THERAPY FOR PEOPLE WITH APHASIA

Published online by Cambridge University Press:  02 December 2013

Nicholas R. Latimer ,
Simon Dixon  and
Rebecca Palmer
Nicholas R. Latimer
Affiliation:
School of Health and Related Research, University of Sheffield
Simon Dixon
Affiliation:
School of Health and Related Research, University of Sheffield
Rebecca Palmer
Affiliation:
School of Health and Related Research, University of Sheffield
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Abstract

Objectives: The aim of this study was to examine the potential cost-effectiveness of self-managed computer therapy for people with long-standing aphasia post stroke and to estimate the value of further research.

Methods: The incremental cost-effectiveness ratio of computer therapy in addition to usual stimulation compared with usual stimulation alone was considered in people with long-standing aphasia using data from the CACTUS trial. A model-based approach was taken. Where possible the input parameters required for the model were obtained from the CACTUS trial data, a United Kingdom-based pilot randomized controlled trial that recruited thirty-four people with aphasia and randomized them to computer treatment or usual care. Cost-effectiveness was described using an incremental cost-effectiveness ratio (ICER) together with cost-effectiveness acceptability curves. A value of information analysis was undertaken to inform future research priorities.

Results: The intervention had an ICER of £3,058 compared with usual care. The likelihood of the intervention being cost-effective was 75.8 percent at a cost-effectiveness threshold of £20,000 per QALY gained. The expected value of perfect information was £37 million.

Conclusions: Our results suggest that computer therapy for people with long-standing aphasia is likely to represent a cost-effective use of resources. However, our analysis is exploratory given the small size of the trial it is based upon and therefore our results are uncertain. Further research would be of high value, particularly with respect to the quality of life gain achieved by people who respond well to therapy.

Keywords

AphasiaComputer-assisted therapySelf-managementCost-effectiveness analysis
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 4 , October 2013 , pp. 402 - 409
Copyright
Copyright © Cambridge University Press 2013 

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