Mindfulness-Based Cognitive Therapy Versus Treatment as Usual in Adults with ADHD: a Trial-Based Economic Evaluation
L. Janssen, Janneke Grutters, Melanie P. J. Schellekens, Cornelis C. Kan, Pieter J Carpentier, Bram Sizoo, Sevket Hepark, J. Buitelaar, Anne E. M. Speckens
Mindfulness March 23, 2019 DOI: 10.1007/s12671-019-01133-7 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Trial-based economic evaluation alongside a randomized trial Peer reviewed |
|---|---|
| Sample size | 96 |
| Population | Adults with ADHD |
| Interventions | Mindfulness-based cognitive therapy (MBCT) treatment as usual (TAU) |
| Duration | 9 months |
| Measures | quality adjusted life years (QALYs), response rate |
| Topics | Meditation |
| Key findings | MBCT added to TAU was associated with higher societal costs but also more QALYs and a much higher response rate than TAU alone (31% vs 6%). The incremental cost was €21,963 per QALY gained and €389 per responder; at a €30,000 per QALY threshold the probability of cost-effectiveness was 51%, and sensitivity analyses generally favored MBCT + TAU. |
Abstract
ADHD has a considerable economic impact. The aim of this study is to conduct a trial-based economic evaluation of mindfulness-based cognitive therapy (MBCT) added to treatment as usual (TAU) versus TAU in adults with ADHD. A Dutch economic evaluation with a time horizon of 9 months was conducted from the societal perspective in the intention-to-treat (ITT) sample. Costs were assessed with a self-report questionnaire. Outcomes were expressed in quality adjusted life years (QALYs) and response rate. Bootstrap simulations were performed to estimate mean costs, QALYs, response rate, incremental cost-effectiveness ratios (ICERs), and associated uncertainty. Additional sensitivity analyses were done with imputed data, without extreme cost outliers, using the per protocol sample, and from a health care perspective. In the ITT sample, societal costs were €3572 for MBCT + TAU (n = 47; 95% CI 2416 to 4995) and €3389 for TAU (n = 49; 2327 to 4763). Average QALYs were 0.542 (0.522 to 0.563) per patient for MBCT + TAU and 0.534 (0.511 to 0.556) for TAU. In MBCT + TAU, more patients responded than in TAU (31% versus 6%; M bootstrapped difference 25%, 12 to 40%). ICERs were €21,963 per QALY gained and €389 per responder. At a threshold of €30,000 per QALY, the probability of MBCT being cost-effective was 51%. All sensitivity analyses showed more favorable results for MBCT + TAU. In most analyses, MBCT was found to be more costly and effective, particularly in terms of disease-specific outcome, than TAU. If the threshold exceeds €30,000 per QALY and €1000 per responder, MBCT seemed cost-effective in treating adult ADHD.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 3
- The impact of mindfulness therapy in individuals with Attention Deficit Hyperactivity Disorder (ADHD): a systematic review ( El impacto de la terapia mindfulness en personas con Trastorno por Déficit de Atención/Hiperactividad (TDAH): una revisión sistemática ) Journal for the Study of Education and Development Infancia y Aprendizaje May 2, 2023
- Cost-Effectiveness of a Child and Parent Mindfulness-Based Training Versus Medication for Childhood ADHD. Journal of Attention Disorders August 24, 2026
- Economic Evaluations of Mindfulness-Based Interventions: a Systematic Review. Mindfulness 2022
Cites 12
- Mindfulness-based cognitive therapy for depression August 21, 2006
- Neural mechanisms of attentional control in mindfulness meditation Frontiers in Neuroscience 2013
- Competence in Teaching Mindfulness-Based Courses: Concepts, Development and Assessment Mindfulness September 21, 2011
- Mindfulness-based cognitive therapy for depression. Industrial Psychiatry Journal October 29, 2024
- The Feasibility, Effectiveness, and Process of Change of Mindfulness-Based Cognitive Therapy for Adults With ADHD: A Mixed-Method Pilot Study. Journal of Attention Disorders April 2020
and 7 more in the library