Maudsley CFS CBT price list, claims treatment 'can' result in return to work

[Dolphin]

So neither Chalder or White's CFS services are cost effective?

Does Sharpe work for a centre providing a clinical service? Would be pretty funny if the Cost-effectiveness paper found that none of the PI's were providing a cost effective service, but was still presented as being a big success for them.

Don't think he's associated with any CFS services at the moment? Here's a profile page: http://www.psych.ox.ac.uk/team/PIs/michael-sharpe

 

[Tom Kindlon]

So neither Chalder or White's CFS services are cost effective?

This refers to my second comment also which I just posted now which other people wouldn't have seen unless they went to the site:

GET costs more at Saint Bartholomew's Hospital (Barts) (one of the trial centre) than the estimate, meaning therapy there is not cost effective when a QALY is valued at £30,000 in healthcare costs

http://www.plosone.org/annotation/listThread.action?root=78707

 

[Esther12]

How did they calculate costs of CBT/GET in the cost-effectiveness paper?

It looks like they just stated them:

Service Use and Costs
In our analysis we adopted both a healthcare and a societal perspective. (The latter includes lost employment and unpaid informal care as well as health costs.) The number and duration of APT, CBT, GET and SMC treatment sessions actually delivered were recorded and time added for preparation, related correspondence, and supervision. It was assumed that the ratio of time spent on patient-related versus support activities was 1:0.3 and that capital and administrative overheads were 46% [12]. The cost per hour of therapy was £110 for CBT and £100 for APT and GET. The cost of SMC was based on the cost per hour of consultant physician time in face-to-face contact with patients, which was £169 [12].

If they just get to say that their treatments cost whatever they want, then it's not hard to claim that they are cost effective.

 

[Esther12]

Just looking at another piece of Maudsley CFS promotional literature:

https://www.national.slam.nhs.uk/wp-content/uploads/2011/06/Chronic-Fatigue-Service-booklet.pdf

They provide some figures and graphs, none of which include data for a control group (well there's one that compares CBT and a psycho-educational intervention, but there was no real difference between them).

Treatment is effective, with around 65% of people improving
with either CBT or GET, and around 25% of people making
a full recovery.

Mainly it's anecdotes (most seemed to be from teens, even though the unit is for 14-adult):

»
My sessions with my therapist have been invaluable. They have
been underpinned by a spirit of empathy, collaboration and
respect. Returning to work, managing the phased return and
handling work in a healthy way have been the main themes
around which treatment has been centred...my return to
work would have been far more difficult without her help and
support and to be honest I’m not certain I would have managed
it successfully.
«
Alice

Expected outcomes may include:
Resuming daily activities
›
Establishing a sleep routine
›
Addressing associated anxiety or depression
›
Challenging problematic beliefs which interfere
›
with progress, which may relate to the rehabilitation
programme, perfectionism or low self-esteem
Making lifestyle changes which may help to prevent
›
relapse at a later date

From one of their successful cases:

After the therapy finished, two years ago, I met my
therapists again three times at three-month intervals
to discuss how things were going, which was really
helpful. Since then, I’ve done some more talking therapy,
I’ve seen a homeopath and I’ve been practising a Taoist
type of yoga and meditation.

...

Acupuncture has also been incredible for me.

...

One really
important thing is that I don’t consider myself as
someone with chronic fatigue syndrome anymore.
I don’t tell anyone about it and people don’t see
me as being ill

 

[Bob]

Treatment is effective, with around 65% of people improving with either CBT or GET, and around 25% of people making a full recovery.

I don't know where they get the 65% figure from. It's not an accurate PACE trial result even if the effects of SMC are included. I think they may have got even more confused than usual. For 'full recovery' I think they are referring to the type of recovery that can mean deterioration.