Methods: This health–economic evaluation alongside a randomized controlled trial included 155 patients with a psychotic disorder in care as usual (CAU), with comorbid PTSD. Participants received eye movement desensitization and reprocessing (EMDR) (n = 55), prolonged exposure (PE) (n = 53) or waiting list (WL) (n = 47) with masked assessments at baseline (T0) and at the two-month (post-treatment, T2) and six-month follow-up (T6). Costs were calculated using the TiC-P interview for assessing healthcare consumption and productivity losses. Incremental cost-effectiveness ratios and economic acceptability were calculated for quality-adjusted life years (EQ-5D-3L-based QALYs) and PTSD ‘Loss of diagnosis’ (LoD, CAPS).
Results: Compared to WL, costs were lower in EMDR (-€1410) and PE (-€501) per patient per six months. In addition, EMDR (robust SE 0.024, t = 2.14, p = .035) and PE (robust SE 0.024, t = 2.14, p = .035) yielded a 0.052 and 0.051 incremental QALY gain, respectively, as well as 26% greater probability for LoD following EMDR (robust SE = 0.096, z = 2.66, p = .008) and 22% following PE (robust SE 0.098, z = 2.28, p = .023). Acceptability curves indicate high probabilities of PTSD treatments being the better economic choice. Sensitivity analyses corroborated these outcomes.
Conclusion: Adding PTSD treatment to CAU for individuals with psychosis and PTSD seem to yield better health and less PTSD at lower costs, which argues for implementation.
Bibliographical noteSpanish title: Beneficios en la economía de la salud del tratamiento del trauma en psicosis.
Chinese title: 治疗精神病症（psychosis）中的创伤的健康-经济收益分析.
- KEA CUA Cost-effectiveness psychosis TTIP psychotic disorder QALY quality-adjusted life years PTSD EMDR prolonged exposure
VU Research Profile
- Human Health and Life Sciences
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Bont, P. A. J. M. D. (Contributor), Vleugel, B. M. V. D. (Contributor), Berg, D. P. G. V. D. (Contributor), Roos, C. D. (Contributor), Lokkerbol, J. (Contributor), Smit, F. (Contributor), Jongh, A. D. (Contributor), Gaag, M. V. D. (Contributor) & Minnen, A. V. (Contributor), Unknown Publisher, 1 Jan 2019
de Bont, P. A. J. M. (Contributor), van der Vleugel, B. M. (Contributor), van den Berg, D. P. G. (Contributor), de Roos, C. (Contributor), Lokkerbol, J. (Contributor), Smit, F. (Contributor), de Jongh, A. (Contributor), van der Gaag, M. (Contributor) & van Minnen, A. (Contributor), Unknown Publisher, 1 Jan 2021
De Bont, P. A. J. M. (Contributor), Van Der Vleugel, B. M. (Contributor), Van Den Berg, D. P. G. (Contributor), De Roos, C. (Contributor), Lokkerbol, J. (Contributor), Smit, F. (Contributor), De Jongh, A. (Contributor), Van Der Gaag, M. (Contributor) & Van Minnen, A. (Contributor), Unknown Publisher, 1 Jan 2019