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

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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 & Outcomes Research
Volume20
Issue number3
DOIs
Publication statusPublished - Jun 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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