Predicting effect and evaluating cost-effectiveness of a family intervention after acquired brain or spinal cord injury: a randomized controlled trial

Objective: To predict treatment response of a family intervention and investigate its cost-effectiveness from a healthcare payer perspective. Design: Explorative predictor analyses and trial-based economic evaluation. Subjects/Patients: Participants (n=157) were enrolled 4 months to 2 years after discharge from a specialized neurorehabilitation unit. Methods: Injury type, time since injury, delivery format, and relationship (individual with injury vs family member) were explored as predictors of effect using linear mixed-effect regression. Cost-effectiveness was analysed from a healthcare payer perspective, with incremental cost based on delivery. Incremental health effect was reported for measures on mental health and anxiety and depression symptoms. Results: The 4 predictors had negligible to small effects on the treatment response. Incremental cost for the family intervention was estimated at €798.16 (CI: €700.9; €895.5). Incremental health effect was estimated at 5.64 (CI: 2.71, 8.56) points on the Mental Component Summary at 2 months’ follow-up. At a willingness-to-pay threshold of €300, the probability of the intervention being cost-effective was 99.8% for the Mental Component Summary. Conclusion: The predictors showed no or little effect on the treatment response, and the cost-effectiveness analysis showed the probabilities of the intervention being cost-effective from a health payer perspective.