Economic evaluation in the field of mental health: conceptual basis

Abstract

Objective: Technological advances in medicine have given rise to a dilemma concerning the use of new health technologies in a context of limited financial resources. In the field of psychiatry, health economic evaluation is a recent method that can assist in choosing interventions with different cost and/or effectiveness for specific populations or conditions. This article introduces clinicians to the fundamental concepts required for critical assessment of health economic evaluations. Methods: The authors conducted a review with systematic methods to assess the essential theoretical framework of health economic evaluation and mental health in Brazil through textbooks and studies indexed in the PubMed, Cochrane Central, LILACS, NHS CRD, and REBRATS databases. A total of 334 studies were found using the specified terms (MeSH -Mental Health AND Economic, Medical) and filters (Brazil AND Humans); however, only five Brazilian economic evaluations were found. Results and conclusions: Economic evaluation studies are growing exponentially in the medical literature. Publications focusing on health economics as applied to psychiatry are increasingly common, but Brazilian data are still very incipient. In a country where financial resources are so scarce, economic analyses are necessary to ensure better use of public resources and wider population access to effective health technologies.

Italian regional health service costs for diagnosis and 1-year treatment of ADHD in children and adolescents

“…social care, housing, and employment [27, 60]. Service utilization, outpatient care, and medications, however, are described as the main components of the economic impact of a disorder in mental health [3]. Second, although the Lombardy Region is the most populated region in Italy, representing about 17% of the national health care costs, all data originated from a single region of Italy, and this may affect the generalizability and comparability of the reported findings.…”

“…Methodological complexities justified the lack of comprehensive estimates of the economic impact associated with the burden of psychiatric disorders [3, 4]. World-wide up to 20% of children and adolescents suffer from a neuro-psychiatric condition; in developed countries, both mental and neurological disorders account for the 40% of the burden of all brain diseases and for the 35% in Europe only [5–8].…”

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

“…It may sound incoherent that LMICs, which should be saving money, are probably those that are wasting it most. 39 Recent studies have pointed out the necessity of cost-effectiveness studies for LMICs, 40 but, to the best of our knowledge, the present work is the first to show an advantageous economic option for a chronic disease which can be treated with MPH-IR even in low-resource settings. 41 In addition, our study demonstrated that, in LMICs, investments in such analyses can reveal a favorable scenario in contrast with wealthy countries.…”

Second Version of the Short Form 6-Dimension Value Set Elicited From Patients With Breast and Colorectal Cancer

“…Economic evaluation is a cornerstone in the decision-making process to figure out the optimal choice regarding the population’s growing needs in health care 1–4 . Economic evaluation uses numerous methods to enlighten decision-makers on the most impactful and effective programs for people’s health 5 .…”

“…E conomic evaluation is a cornerstone in the decisionmaking process to figure out the optimal choice regarding the population's growing needs in health care. [1][2][3][4] Economic evaluation uses numerous methods to enlighten decisionmakers on the most impactful and effective programs for people's health. 5 Among these methods, cost-utility analysis (CUA) has been recommended by many health agencies and allows quantification of programs' effects through multidimensional indicators of health-related quality of life (HRQoL).…”