Cost-effectiveness of preventing first-episode psychosis in ultra-high-risk subjects: multi-centre randomized controlled trial

Ising, Helga K.; Smit, Filip; Veling, Wim; Rietdijk, Judith; Dragt, Sara; Klaassen, Rianne; Savelsberg, N. S. P.; Boonstra, Nynke; Nieman, Dorien H.; Linszen, Don; Wunderink, Lex; Gaag, Mark van der

doi:10.1017/s0033291714002530

Cited by 52 publications

(72 citation statements)

References 38 publications

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“…35,[38][39][40][41] The cost-effectiveness plane in this study at 48-month follow-up was further improved compared with the 18-month follow-up. This study showed that CBTuhr had an 83% likelihood of resulting in a reduction of the transition to psychosis at a lower cost.…”

Section: Resultsmentioning

confidence: 53%

“…Also from the societal perspective, there is a substantial likelihood (73% in the primary and 78% in the secondary analysis) that CBTuhr results in more effects at lower costs. The conclusions indicate that the results of the 18 months analysis 35 do not deteriorate when considering a period of 4 years and guided some patients through a critical period with declining transition rates. 36 …”

Section: Main Findingsmentioning

confidence: 83%

“…Besides the proportion of averted transitions to psychosis, 9,35 the difference in QALYs showed a clinically relevant but statistically nonsignificant effect of the intervention on the lives of at-risk individuals and at least no deterioration in their health-related quality of life.…”

Section: Clinical and Public Health Relevancementioning

confidence: 98%

“…The costs of identifying the UHR patients and training staff (US$724) were not factored into the cost of intervention, because they are the same for both groups. For further information, see Ising et al 35 Actual implementation of the intervention would, however, require an additional US$724 per identified patient, thereby lowering the observed cost reduction of US$5777 with US$724 per patient. This would decrease the probability of more effects at lower costs from 83% to 79% in the primary analysis and from 75% to 72% in the secondary analysis.…”

Section: Costs Of Identifying Uhr Patientsmentioning

confidence: 99%

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Four-Year Cost-effectiveness of Cognitive Behavior Therapy for Preventing First-episode Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial

Ising

Lokkerbol

Rietdijk

et al. 2016

SCHBUL

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Background . This study aims to evaluate the long-term costeffectiveness of add-on cognitive behavior therapy (CBT) for the prevention of psychosis for individuals at ultrahigh risk (UHR) of psychosis. Method. The Dutch Early Detection and Intervention randomized controlled trial was used, comparing routine care (RC; n = 101) with routine care plus CBT for UHR (here called CBTuhr; n = 95). A cost-effectiveness analysis was conducted with treatment response (defined as proportion of averted transitions to psychosis) as an outcome and a cost-utility analysis with quality-adjusted life years (QALYs) gained as a secondary outcome. Results. The proportion of averted transitions to psychosis was significantly higher in the CBTuhr condition (with a risk difference of 0.122; b = 1.324, SE b = 0.017, z = 7.99, P < 0.001). CBTuhr showed an 83% probability of being more effective and less costly than RC by −US$ 5777 (savings) per participant. In addition, over the 4-year follow-up period, cumulative QALY health gains were marginally (but not significantly) higher in CBTuhr than for RC (2.63 vs. 2.46) and the CBTuhr intervention had a 75% probability of being the superior treatment (more QALY gains at lower costs) and a 92% probability of being costeffective compared with RC at the Dutch threshold value (US$ 24 560; €20 000 per QALY). Conclusions. Add-on preventive CBTuhr had a high likelihood (83%) of resulting in more averted transitions to psychosis and lower costs as compared with RC. In addition, the intervention had a high likelihood (75%) of resulting in more QALY gains and lower costs as compared to RC.

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Section: Resultsmentioning

confidence: 53%

Section: Main Findingsmentioning

confidence: 83%

Section: Clinical and Public Health Relevancementioning

confidence: 98%

Section: Costs Of Identifying Uhr Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Four-Year Cost-effectiveness of Cognitive Behavior Therapy for Preventing First-episode Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial

Ising

Lokkerbol

Rietdijk

et al. 2016

SCHBUL

View full text Add to dashboard Cite

show abstract

“…Ising et al [14] studied the cost-effectiveness and cost utility of CBT in the prevention of first-episode psychosis. In this multicenter trial, 196 ultra-high-risk (as determined by the Comprehensive Assessment of At-Risk Mental States - CAARMS) were assigned to either routine care (101 subjects) or to routine care plus add-on individual CBT aiming at the prevention of a first episode of psychosis (95 subjects).…”

Section: Early Intervention and Preventionmentioning

confidence: 99%