MedWire News: A program of early intervention for patients with a first episode of psychosis is likely to be cost-effective in terms of improved vocational and quality-of-life outcomes, study results show.
The intervention reduced total expenditure by one third compared with standard care, suggesting that the cost of the service is offset by reduced hospitalizations.
“It is important, given limited resources, to determine whether early intervention represents good value for money,” Paul McCrone (King’s College London, UK) and colleagues comment in the British Journal of Psychiatry.
The study included 144 individuals aged 16–40 years who were referred to mental health services in Lambeth, South London, with a probable diagnosis of non-affective psychosis.
Roughly half the patients were randomized to receive care from the Lambeth Early Onset (LEO) team, which included psychiatrists, psychologists, occupational therapists, nurses, and healthcare assistants. The remaining patients received standard care.
After 18 months of follow-up, patients in the intervention group had spent an average of 35.5 days in hospital compared with 54.9 days in the standard care group.
The total average cost incurred by each patient during follow-up was £11,685 (US$ 17,257) in the early intervention group and £14,062 (US$ 20,768) in the standard care group, although the difference was not significant.
Next, the researchers performed a cost-effectiveness analysis using the net-benefit approach. This is based on the theoretical value that society would place on a 1-unit improvement in quality of life or of someone making a vocational recovery.
Calculations showed that if society would not be willing to pay anything for an individual who makes a full or partial vocational recovery there is a 76% likelihood of early intervention being the most cost-effective option – increasing steadily as the willingness to pay increased.
Similarly, with a value of zero placed on a unit difference in the Manchester Short Assessment of Quality of Life, there was a 92% likelihood of early intervention being the most cost-effective option, also increasing as the willingness to pay increased.
“Early intervention did not increase costs and was highly likely to be cost-effective when compared with standard care,” McCrone et al conclude.
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