Panic disorder cost-effectiveness

Shah and Jenkins (2000) in a review of mental health economic studies from around the world identified 40 cost-of-illness studies, of which five covered all disorders, one neuroses, two panic disorders and one anxiety. All were from developed countries. There were numerous cost-effectiveness studies but none involving the anxiety disorders specifically. One study in the UK examined the cost-benefit analysis of a controlled trial of nurse therapy for neurosis in primary care (Ginsberg et al, 1984). 

Treating a condition is usually cheaper than not treating it (the offset effect). A Spanish study of panic disorder patients reported an offset effect of 14% following 12 months of drug treatment (Salvador-Carulla et al, 1995). Thus, the total direct costs of health-care use during the previous year and the year following diagnosis were US 29 000 and US 46 000 respectively, but the estimated... 

Salvador-Carulla L, Segui J, Fernandez-Cano P, et al (1995). Costs and offset effect in panic disorders. Br J Psychiatry 166 (suppl. 27), 23-8. 

Heuzenroeder, L., M. Donnelly, M. M. Haby, C. Mihalopoulos, R. Rossell, R. Carter, G. Andrews, and T. Vos. Cost-effectiveness of Psychological and Pharmacological Interventions for Generalized Anxiety Disorder and Panic Disorder. Australian and New Zealand Journal of Psychiatry 38 (2004) 602-612. 

The nasal route is generating increasing interest as a route for the administration of local treatments and a cost-effective and patient-friendly alternative to injection for systemic delivery [49]. The special advantages of nasal delivery make it attractive for (i) crisis treatment where rapid onset of action is desirable (e.g., pain, migraine, panic attacks), (ii) systemic delivery of compounds that at present can only be delivered by injection (peptides/pro-proteins/vaccination), and (iii) direct targeting of the CNS (polar drugs for the treatment of CNS disorders). 

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