Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo

Chang, Wei‐Lun; Andersen, Carit Jacques; Berisha, Besa Shatri; Estrup, Olena; Wang, Shr‐Jie

doi:10.2340/16501977-2322

Cited by 5 publications

(35 citation statements)

References 18 publications

(25 reference statements)

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“…The earliest EE was published in 1997 (Fontana & Rosenheck, 1997) and the most recent EE was published in 2019 (Aas et al, 2019) (Table 1). Ten studies were conducted in the USA (Cohen et al, 2017;Domino et al, 2005;Fontana & Rosenheck, 1997;Gilbert, 2009;Greer et al, 2014;Le et al, 2014;Morland et al, 2013;Painter et al, 2017;Slade et al, 2017;Wood et al, 2009), three in Australia (Gospodarevskaya & Segal, 2012;Issakidis et al, 2004; and five in Europe (Aas et al, 2019;Chang et al, 2018;Macdonald et al, 2016;McCrone et al, 2005;Shearer et al, 2018).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Nine studies measured costs from a healthcare payer's perspective (Cohen et al, 2017;Domino et al, 2005;Gilbert, 2009;Gospodarevskaya & Segal, 2012;Issakidis et al, 2004;Mihalopoulos & Chatterton, 2015;Painter et al, 2017;Shearer et al, 2018;Slade et al, 2017). Two studies measured costs from a societal perspective (Chang et al, 2018;Le et al, 2014) and one study from a mental health service provider perspective (McCrone et al, 2005). Six studies did not report the perspective used for cost-measurement (Aas et al, 2019;Fontana & Rosenheck, 1997;Greer et al, 2014;Macdonald et al, 2016;Morland et al, 2013;Wood et al, 2009).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…No study reported the cost-effectiveness of non-TF-CBT and EMDR. Four studies determined the cost-effectiveness of integrated care, in particular, stepped care (Cohen et al, 2017), telemedicine-based collaborative care (Painter et al, 2017), comprehensive, integrated, trauma-informed and patient-involved services (CIT and CSR-involved services) (Domino et al, 2005), and a multidisciplinary rehabilitation program (Chang et al, 2018). Furthermore, one EE determined the cost-effectiveness of optimal treatment (Issakidis et al, 2004).…”

Section: Aims and Outcomesmentioning

confidence: 99%

“…Most of the included trialbased and model-based EEs were of moderate to good quality based on the CHEC list and the ISPOR questionnaire, and fulfilled 53% to 95% and 67% to 87% of the particular criteria, respectively (Tables 5 and 6) (Aas et al, 2019;Cohen et al, 2017;Domino et al, 2005;Fontana & Rosenheck, 1997;Gilbert, 2009;Gospodarevskaya & Segal, 2012;Le et al, 2014;McCrone et al, 2005;Painter et al, 2017;Shearer et al, 2018;Slade et al, 2017). All EEs with a time horizon longer than 12 months applied a discount rate to measured costs and effects (Chang et al, 2018;Cohen et al, 2017;Gospodarevskaya & Segal, 2012;Shearer et al, 2018) except for one EE (Aas et al, 2019). Overall, the quality of full EEs was better than the quality of partial EEs according to the CHEC list (71% vs. 49%).…”

Section: Quality Assessmentmentioning

confidence: 99%

“…To date, the cost-effectiveness of the second-line treatment EMDR for the treatment of adults with PTSD has not been evaluated. With respect to models of integrated care, it has become apparent that CIT and CSR-involved services stepped care + non-TF-CBT and multidisciplinary rehabilitation programs were cost-effective for the treatment of adults with PTSD, compared with TAU or waiting list (Chang et al, 2018;Cohen et al, 2017;Domino et al, 2005). Telemedicine-based collaborative care, however, was not cost-effective, when compared with TAU (Painter et al, 2017).…”

Section: Excess Costsmentioning

confidence: 99%

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Economic evaluations and cost analyses in posttraumatic stress disorder: a systematic review

Warth

Dams

Grochtdreis

et al. 2020

European Journal of Psychotraumatology

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Background Posttraumatic stress disorder is associated with a high economic burden. Costs of treatment are known to be high, and cost-effectiveness has been analysed for several treatment options. Objective As no review on economic aspects of posttraumatic stress disorder exists, the aim of this study was to systematically review costs-of-illness studies and economic evaluations of therapeutic treatment for posttraumatic stress disorder, and to assess their quality. Method A systematic literature search was performed in March 2017 and was last updated in February 2020 in the databases PubMed, PsychInfo and NHS Economic Evaluation Database. Cost-of-illness studies and economic evaluations of treatment for posttraumatic stress disorder were selected. Extracted cost data were categorized as direct costs and indirect costs and inflated to 2015 US-$ purchasing power parities (PPP). Quality was assessed using an adapted cost-of-illness studies quality checklist, the Consensus on Health Economic Criteria list, and the questionnaire to assess relevance and credibility of modelling studies by the International Society for Pharmacoeconomics and Outcome Research. Results In total, 13 cost-of-illness studies and 18 economic evaluations were included in the review. Annual direct excess costs ranged from 512 US-$ PPP to 19,435 US-$ PPP and annual indirect excess costs were 5,021 US-$ PPP per person. Trauma-focused cognitive-behavioural therapy (+selective serotonin re-uptake inhibitor) was found to be cost-effective compared with treatment as usual and no treatment. Overall, included studies were of low and moderate quality. Studies used inappropriate economic study designs and lacked information on the economic perspective used. Conclusions Posttraumatic stress disorder is a major public health problem that causes high healthcare costs. While trauma-focused cognitive-behavioural therapy was found to be cost-effective, further investigations regarding pharmacotherapy and other treatments are necessary.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Aims and Outcomesmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Excess Costsmentioning

confidence: 99%

See 3 more Smart Citations

Economic evaluations and cost analyses in posttraumatic stress disorder: a systematic review

Warth

Dams

Grochtdreis

et al. 2020

European Journal of Psychotraumatology

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Making an economic argument for investment in global mental health: The case of conflict-affected refugees and displaced people

McDaid

Park

2023

Camb. prisms Glob. ment. health

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Mental health expenditure accounts for just 2.1% of total domestic governmental health expenditure per capita. There is an economic, as well as moral, imperative to invest more in mental health given the long-term adverse impacts of mental disorders. This paper focuses on how economic evidence can be used to support the case for action on global mental health, focusing on refugees and people displaced due to conflict. Refugees present almost unique challenges as some policy makers may be reluctant to divert scarce resources away from the domestic population to these population groups. A rapid systematic scoping review was also undertaken to identify economic evaluations of mental health-related interventions for refugees and displaced people and to look at how this evidence base can be strengthened. Only 11 economic evaluations focused on the mental health of refugees, asylum seekers and other displaced people were identified. All but two of these intervention studies potentially could be cost-effective, but only five studies reported cost per quality-adjusted life year gained, a metric allowing the economic case for investment in refugee mental health to be compared with any other health-focused intervention. There is a need for more consistent collection of data on quality of life and the longer-term impacts of intervention. The perspective adopted in economic evaluations may also need broadening to include intersectoral benefits beyond health, as well as identifying complementary benefits to host communities. More use can be also made of modelling, drawing on existing evidence on the effectiveness and resource requirements of interventions delivered in comparable settings to expand the current evidence base. The budgetary impact of any proposed strategy should be considered; modelling could also be used to look at how implementation might be adapted to contain costs and take account of local contextual factors.

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Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries: a systematic review

Mutyambizi-Mafunda

Myers

Sorsdahl

et al. 2022

Health Policy and Planning

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Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings, and appraises the quality of economic evaluations of psychological treatments for CMDs in LMICs. We searched a range of bibliographic databases (including PubMed, EconLit, APA-PsycINFO, Cochrane library) and the African Journals Online and Google Scholar platforms. We used a pre-populated template to extract data and the Drummond & Jefferson checklist for quality appraisal. We present results as a narrative synthesis. The review included 26 studies mostly from Asia (12) and Africa (9). The majority were Cost-Effectiveness Analyses (CEAs) (12), some were Cost-Utility Analyses (CUAs) (5), with one Cost-Benefit Analysis (CBA), or combinations of economic evaluations (8). Most interventions were considered either cost-effective or potentially cost-effective (22), with 3 interventions not cost-effective. Limitations were noted regarding appropriateness of conclusions drawn on cost-effectiveness, the use of Cost-Effectiveness Thresholds (CETs), and application of “societal” Incremental Cost-Effectiveness Ratios (ICERs) to reflect value for money of treatments. Non-specialist health workers (NSHW) delivered most of the treatments (16) for low-cost delivery at scale, and costs should reflect the true opportunity cost of NSHW time to support the development of a sustainable cadre of health care providers. There is a four-fold increase in economic evaluations of CMD psychological treatments in the last decade over the previous one. Yet, findings from this review highlight the need for better application of economic evaluation methodology to support resource allocation towards World Health Organization (WHO) recommended first line treatments of CMDs. We suggest impact inventories to capture societal economic gains and propose a value for money assessment framework to guide researchers in evaluating cost-effectiveness.

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Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo

Abstract: Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.

Cited by 5 publications

References 18 publications

Economic evaluations and cost analyses in posttraumatic stress disorder: a systematic review

Economic evaluations and cost analyses in posttraumatic stress disorder: a systematic review

Making an economic argument for investment in global mental health: The case of conflict-affected refugees and displaced people

Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries: a systematic review

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