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

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
JournalExpert review of pharmacoeconomics & outcomes research
DOIs
Publication statusE-pub ahead of print - 20 Jun 2019

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