Cost-effectiveness and budget impact of specialized psychotherapy for borderline personality disorder A synthesis of the evidence

We present a method for the synthesis of evidence for cost-effectiveness and budget impact analysis with a specific application to specialized outpatient psychotherapy for borderline personality disorder in the Netherlands. Following a systematic literature search, a model-based economic evaluation is performed in which simulated patient-level data are used to provide overall estimates of the incremental costs and incremental effects. These are then used to assess the cost-effectiveness and budget impact of specialized outpatient psychotherapy for borderline personality disorder in the Netherlands. The results indicate that specialized outpatient psychotherapy for BPD can be considered cost-effective and that its scaling up to Dutch national level would require an investment of € 2.367 million (95% C.I.: € 1,717,000 - € 3,272,000) per 1,000 additional patients with BPD. Sensitivity analyses demonstrated the robustness of our findings, but also their sensitivity to the choice of included studies based on the comparator condition.