Table 6 Summary of the accrued evidence for the cost impact of ABAs

Reporting only implementation and running costs (IRC)

Gitlin, USA, 2012 [36]

Not applicable

Resource-intensive home delivery;

Resource cost compare favourable to brand name antidepressants

Yes

Yes

Reporting implementation and running costs AND health and/or social care related costs (IRHSC)

Mayer, USA, 2010 [32]

ABA dominant against comparator

Reported non-significant health care cost saving and

difference in hospitalisation;

Sample participants had significantly lower comorbidity

(major driver in hospitalisation) than non-participants

Unreported

Unreported

Ellis-Hill, UK, 2019 [34]

Not applicable

All possible primary outcome measures demonstrate change in favour of ABA intervention;

Measures of emotional well-being would be a more relevant study outcome

Yes

Unreported

Including an economic evaluation (EE)

Kahn, USA, 2001 [31]

Cost effective against comparator

Cost per HIV infection averted is far less than the lifetime

medical costs of HIV disease;

$18,000 or less per infection averted (excluding savings from HIV medical costs averted)

Unreported

Unreported

Stevens, UK, 2002 [40]

Cost effectiveness implied (no explicit statement)

ICER = £105 per life year gained (95% CI: £33–391);

Modal value: £90 per life year gained;

Mean cost per additional 1-year quitter £825 (95% CI: £300–3500)

Unreported

Unreported

Krukowski, USA, 2013 [35]

ABA dominant against comparator

Implementation cost per kilogram lost was $45;

Comparable weight loss;

LHE delivered service cost almost half

as much professionally delivered service;

May reached more high-risk individuals

Unreported

Unreported

Pizzi, USA, 2014 [37]

Cost effective against threshold value [Threshold: US $50,000-$100,000/QALY]

Cost-effective treatment for managing depressive symptoms in older African Americans that compares favourably with the cost-effectiveness of previously tested approaches

Cost per QALY range of $30,500-$76,500

Yes

Yes

Eckermann, Australia, 2014 [33]

Cost effectiveness implied

Successful health promotion program with high community network impact and return on investment in practice;

Multiplier impact on total community activity up to two years was 5.07 ($226,737 against $44,758 invested)

Unreported

Unreported

Wingate, UK, 2017 [41]

Cost effective against comparator

1:1 and group peer support over 8–12 months are cost saving in this setting, largely derived by difference in self-reported utilisations. Long term benefits should be investigated;

Overall cost savings of £113.13 per participant per annum

Unreported

Unreported

Chung, USA, 2018 [38]

Comparator dominant against ABA

Conservatively, higher start-up costs in ABA (to engage staff) though reflected increase attendance. Comparator intervention has a time-limited lifetime, longer time horizon may alter result. No significant differences in 12-month service-use costs

Unreported

Yes

Visram, UK, 2020 [42]

Cost effective against threshold value [Threshold: GBP £20,000-£30,000/QALY]

£3,900/QALY gained (comparing favourably with typical UK threshold);

Societal value of at least £3.45 for every £1 spent on the service;

Model not designed for holistic, multi-component services and therefore possible results represent over- or under- estimation

Unreported

Unreported

Yeary, USA, 2020 [39]

Inconclusive. ABA likely dominant against comparator

$138 per kg lost;

In previous studies cost analyses were not conducted separately by race and ethnicity. “Given black typically lose less weight than whites in behavioural weight loss intervention, cost per pound lost may have been considerably high among blacks”

Unreported

Unreported