What information is there on cost?

Estimated cost to the NHS associated with PES (‘MUS’) of £3.1 billion17. However, about half the cost (£1.2 billion) was spent on the inpatient care of less than 10 per cent of people with PES (‘MUS’) – a relatively small number of people receive very expensive and inappropriate care.

While the economic case for CBT is most compelling if resources are targeted at those with full somatoform disorders, the case for also tackling sub-threshold conditions is strong. All models are likely to be cost saving in the long-term.

Cost models rely on evidence of effectiveness from studies in the United States, which may not be easily generalizable to an English context. However, sensitivity and threshold analyses indicate that, even assuming very limited improvements in health outcomes, investing in actions to tackle somatoform disorders remains cost-effective from a societal perspective under most scenarios.

Pathways can be developed for ‘functional/MUS/physiological explainable symptoms’ with evidence for cost savings being greatest at the severe end using collaborative care.
More information is required on the relative effectiveness of e-learning compared to face-to-face learning as a way of raising GP awareness, because costs are substantially lower.