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The cost-effectieveness of cognitive behavior therapy for borderline personality disorder: Results from the BOSCOT trial

Research output: Contribution to journalArticle


  • Stephen Palmer
  • Kate Davidson
  • Peter Tyrer
  • Andrew Gumley
  • Philip Tata
  • John Norrie
  • Heather Murray
  • Helen Seivewright


Publication details

JournalJournal of personality disorders
DatePublished - Oct 2006
Issue number5
Number of pages16
Pages (from-to)466-481
Original languageEnglish


Borderline personality disorder places a significant burden on health-care providers and other agencies. This study evaluated the cost-effectiveness of cognitive behavior therapy plus treatment as usual compared to treatment as usual alone for patients with borderline personality disorder. The economic analysis was conducted alongside a multi-center, randomized controlled trial. The costs of primary and secondary health-care utilization, alongside the wider economic costs, were estimated from medical records and patient self-report. The primary outcome measure used was the quality-adjusted life year (QALN), assessed using EuroQol. On average, total costs per patient in the cognitive behavior therapy group were lower than patients receiving usual care alone (-689) pound, although this group also reported a lower quality of life (-0.11 QALYs). These differences were small and did not approach conventional levels of statistical significance. The use of cognitive therapy for borderline personality disorder does not appear to demonstrate any significant cost-effective advantage based on the results of this study.

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