Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders

Issakidis, C., Sanderson, K., Corry, J., Andrews, G. and Lapsley, H. (2004) Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders. Psychological Medicine, 34 1: 19-35. doi:10.1017/S003329170300881X


Author Issakidis, C.
Sanderson, K.
Corry, J.
Andrews, G.
Lapsley, H.
Title Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders
Journal name Psychological Medicine   Check publisher's open access policy
ISSN 0033-2917
Publication date 2004
Sub-type Article (original research)
DOI 10.1017/S003329170300881X
Volume 34
Issue 1
Start page 19
End page 35
Total pages 17
Place of publication Cambridge, U.K.
Publisher Cambridge University Press
Collection year 2004
Language eng
Subject C1
321204 Mental Health
730307 Health policy evaluation
1701 Psychology
Abstract Background. The present paper describes a component of a large Population cost-effectiveness study that aimed to identify the averted burden and economic efficiency of current and optimal treatment for the major mental disorders. This paper reports on the findings for the anxiety disorders (panic disorder/agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder and obsessive-compulsive disorder). Method. Outcome was calculated as averted 'years lived with disability' (YLD), a population summary measure of disability burden. Costs were the direct health care costs in 1997-8 Australian dollars. The cost per YLD averted (efficiency) was calculated for those already in contact with the health system for a mental health problem (current care) and for a hypothetical optimal care package of evidence-based treatment for this same group. Data sources included the Australian National Survey of Mental Health and Well-being and published treatment effects and unit costs. Results. Current coverage was around 40% for most disorders with the exception of social phobia at 21%. Receipt of interventions consistent with evidence-based care ranged from 32% of those in contact with services for social phobia to 64% for post-traumatic stress disorder. The cost of this care was estimated at $400 million, resulting in a cost per YLD averted ranging from $7761 for generalized anxiety disorder to $34 389 for panic/agoraphobia. Under optimal care, costs remained similar but health gains were increased substantially, reducing the cost per YLD to < $20 000 for all disorders. Conclusions. Evidence-based care for anxiety disorders would produce greater population health gain at a similar cost to that of current care, resulting in a substantial increase in the cost-effectiveness of treatment.
Keyword Psychiatry
Psychology
Psychology, Clinical
Quality-of-life
Posttraumatic-stress-disorder
Term-follow-up
Social Phobia
Panic Disorder
Primary-care
Service Utilization
United-states
Health-care
Pharmacological Treatment
Q-Index Code C1

 
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Created: Wed, 15 Aug 2007, 03:10:49 EST