Designing and Testing of a Health-Economic Markov Model for Prevention and Treatment of Early Psychosis

Ben F.M. Wijnen*, Frederick W. Thielen, Steef Konings, Talitha Feenstra, Mark Van Der Gaag, Wim Veling, Lieuwe De Haan, Helga Ising, Mickaël Hiligsmann, Silvia M.A.A. Evers, Filip Smit, Joran Lokkerbol

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: This study aims to report on the design of a model to determine the cost-effectiveness of prevention and treatment of early psychosis (PsyMod) and to estimate ten-year cost-effectiveness and budget impact of interventions targeting individuals with ultra-high risk (UHR) of developing psychosis or with first episode psychosis (FEP). Methods: PsyMod was built in parallel with the development of a new standard of care for treatment of early psychosis in the Netherlands. PsyMod is a state-transition cohort simulation model and considers six health states, namely ultra-high risk of psychosis (UHR), FEP, post-FEP, no-UHR, recovery/remission, and death. Results are expressed as total healthcare costs, QALYs, incremental cost-effectiveness ratio (ICER), and budget impact. Results: PsyMod was used to extrapolate budget impact and cost-effectiveness of cognitive behavioural therapy for preventing FEP for individuals at UHR of psychosis (CBTuhr) compared to care as usual. CBTuhr resulted in a per-patient increase of 0.06 QALYs and a per patient cost reduction of €654 (dominant ICER) with a reduction in 5-year healthcare costs of €1,002,166. Conclusions: PsyMod can be used to examine cost-effectiveness and budget impact of interventions targeting prevention and treatment of FEP and is freely available for academic purposes upon request by the authors.

Original languageEnglish
Pages (from-to)269-279
Number of pages11
JournalExpert Review of Pharmacoeconomics and Outcomes Research
Volume20
Issue number3
Early online date20 Jun 2019
DOIs
Publication statusPublished - 3 May 2020

Funding

This study was funded by The Netherlands Organisation for Health Research and Development (ZonMw) Mental Healthcare Fellowship, grant ID 636320003. Steef Konings, Joran Lokkerbol and Talitha Feenstra acknowledge an unrestricted grant from Stichting de Friesland for the IMPROVE project. Their work for the current research project contributed to one of the case studies in IMPROVE.

FundersFunder number
Stichting de Friesland
ZonMw636320003
ZonMw

    Keywords

    • budget impact
    • cost-effectiveness
    • economic evaluation
    • health economic modelling
    • psychosis
    • Schizophrenia

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