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

doi:10.1080/14737167.2019.1632194

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 journal › Article › Academic › peer-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 language	English
Pages (from-to)	269-279
Number of pages	11
Journal	Expert Review of Pharmacoeconomics & Outcomes Research
Volume	20
Issue number	3
DOIs	https://doi.org/10.1080/14737167.2019.1632194
Publication status	Published - 3 May 2020

Keywords

Budgets
Cognitive Behavioral Therapy/economics
Cohort Studies
Computer Simulation
Cost-Benefit Analysis
Health Care Costs/statistics & numerical data
Humans
Markov Chains
Models, Economic
Netherlands
Psychotic Disorders/economics
Quality-Adjusted Life Years
Risk
COST-EFFECTIVENESS ANALYSIS
EARLY INTERVENTION
ULTRA-HIGH-RISK
Schizophrenia
FOLLOW-UP
RISPERIDONE
psychosis
health economic modelling
ANTIPSYCHOTICS
1ST-EPISODE PSYCHOSIS
1ST EPISODE
cost-effectiveness
SCHIZOPHRENIA
budget impact
UNTREATED PSYCHOSIS
economic evaluation

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10.1080/14737167.2019.1632194Licence: CC BY-NC-ND

Cite this

Wijnen, B. F. M., Thielen, F. W., Konings, S., Feenstra, T., Van Der Gaag, M., Veling, W., De Haan, L., Ising, H., Hiligsmann, M., Evers, S. M. A. A., Smit, F., & Lokkerbol, J. (2020). Designing and Testing of a Health-Economic Markov Model for Prevention and Treatment of Early Psychosis. Expert Review of Pharmacoeconomics & Outcomes Research, 20(3), 269-279. https://doi.org/10.1080/14737167.2019.1632194

@article{00407f2d82d94db18fbdbf1406db959b,

title = "Designing and Testing of a Health-Economic Markov Model for Prevention and Treatment of Early Psychosis",

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.",

keywords = "Budgets, Cognitive Behavioral Therapy/economics, Cohort Studies, Computer Simulation, Cost-Benefit Analysis, Health Care Costs/statistics & numerical data, Humans, Markov Chains, Models, Economic, Netherlands, Psychotic Disorders/economics, Quality-Adjusted Life Years, Risk, COST-EFFECTIVENESS ANALYSIS, EARLY INTERVENTION, ULTRA-HIGH-RISK, Schizophrenia, FOLLOW-UP, RISPERIDONE, psychosis, health economic modelling, ANTIPSYCHOTICS, 1ST-EPISODE PSYCHOSIS, 1ST EPISODE, cost-effectiveness, SCHIZOPHRENIA, budget impact, UNTREATED PSYCHOSIS, economic evaluation",

author = "Wijnen, {Ben F M} and Thielen, {Frederick W} and Steef Konings and Talitha Feenstra and {Van Der Gaag}, Mark and Wim Veling and {De Haan}, Lieuwe and Helga Ising and Micka{\"e}l Hiligsmann and Evers, {Silvia M A A} and Filip Smit and Joran Lokkerbol",

note = "Funding Information: 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. Publisher Copyright: {\textcopyright} 2019, {\textcopyright} 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",

year = "2020",

month = may,

day = "3",

doi = "10.1080/14737167.2019.1632194",

language = "English",

volume = "20",

pages = "269--279",

journal = "Expert Review of Pharmacoeconomics & Outcomes Research",

issn = "1473-7167",

publisher = "Routledge/Taylor & Francis Group",

number = "3",

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Wijnen, BFM, Thielen, FW, Konings, S, Feenstra, T, Van Der Gaag, M, Veling, W, De Haan, L, Ising, H, Hiligsmann, M , Evers, SMAA, Smit, F & Lokkerbol, J 2020, 'Designing and Testing of a Health-Economic Markov Model for Prevention and Treatment of Early Psychosis', Expert Review of Pharmacoeconomics & Outcomes Research, vol. 20, no. 3, pp. 269-279. https://doi.org/10.1080/14737167.2019.1632194

TY - JOUR

T1 - Designing and Testing of a Health-Economic Markov Model for Prevention and Treatment of Early Psychosis

AU - Wijnen, Ben F M

AU - Thielen, Frederick W

AU - Konings, Steef

AU - Feenstra, Talitha

AU - Van Der Gaag, Mark

AU - Veling, Wim

AU - De Haan, Lieuwe

AU - Ising, Helga

AU - Hiligsmann, Mickaël

AU - Evers, Silvia M A A

AU - Smit, Filip

AU - Lokkerbol, Joran

N1 - Funding Information: 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. Publisher Copyright: © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2020/5/3

Y1 - 2020/5/3

N2 - 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.

AB - 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.

KW - Budgets

KW - Cognitive Behavioral Therapy/economics

KW - Cohort Studies

KW - Computer Simulation

KW - Cost-Benefit Analysis

KW - Health Care Costs/statistics & numerical data

KW - Humans

KW - Markov Chains

KW - Models, Economic

KW - Netherlands

KW - Psychotic Disorders/economics

KW - Quality-Adjusted Life Years

KW - Risk

KW - COST-EFFECTIVENESS ANALYSIS

KW - EARLY INTERVENTION

KW - ULTRA-HIGH-RISK

KW - Schizophrenia

KW - FOLLOW-UP

KW - RISPERIDONE

KW - psychosis

KW - health economic modelling

KW - ANTIPSYCHOTICS

KW - 1ST-EPISODE PSYCHOSIS

KW - 1ST EPISODE

KW - cost-effectiveness

KW - SCHIZOPHRENIA

KW - budget impact

KW - UNTREATED PSYCHOSIS

KW - economic evaluation

U2 - 10.1080/14737167.2019.1632194

DO - 10.1080/14737167.2019.1632194

M3 - Article

C2 - 31195900

SN - 1473-7167

VL - 20

SP - 269

EP - 279

JO - Expert Review of Pharmacoeconomics & Outcomes Research

JF - Expert Review of Pharmacoeconomics & Outcomes Research

IS - 3

ER -