The cost-utility of an intervention for families with a parent having a mental illness: A health economic evaluation of a randomized controlled trial

Abstract

Background: Children of families with a parent with a mental illness have an increased risk of developing mental health problems. Therefore, children and adolescents living in families with a parent with mental illness are regarded as a target group for selective prevention. To date, only a few economic evaluation studies for interventions directed at preventing the intergenerational transmission of mental health problems exist. The cost utility of an intervention for the support of families with a parent having a mental illness will be estimated from the perspective of the German health and social care system. Methods: A total of 214 families with 337 children and adolescents were randomly assigned to the intervention (INT) group (108/170) or the control (TAU) group (106/167). Families in the intervention group received at least eight intervention sessions (50 to 90 minutes) over six months. Total costs of illness were estimated by means of the Children and Adolescent Mental Health Service Receipt Inventory (CAMHSRI) over 24 months. Quality-adjusted live years (QALYs) were estimated on the basis of the KIDSCREEN-10. An incremental cost-utility analysis was performed by means of the net-benefit approach. Results: The average total annual cost was estimated to be €3,784.59 (SD € 8,581.11) in the TAU group and € 3,264.44 (SD € 9,431.89) in the INT group, the annual cost difference between INT and TAU was € -516.14 (SE 1,124.95) which was not significant at p ≤ 0.05. The average QALY was estimated to be 0.759 (SD 0.073) in the TAU group and 0.763 (SD 0.072). The QALY difference between INT and TAU was 0.0037 (SE 0.0092) which was not significant at p ≤ 0.05. The incremental cost utility ratio (ICUR) indicated that the gain of one additional year in full health by means of the intervention was associated with the saving of €139.49. However, the stochastic insecurity of the ICUR did not allow a unique decision about the cost-utility of the intervention. Conclusions: More information on the economic value of the intervention for families with a parent with mental illness in comparison to treatment as usual in Germany is needed. Trial registration: ClinicalTrials.gov, identifier NCT02308462; German Clinical Trials Register: DRKS00006806.