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Cost-effectiveness of an early intervention service for people with psychosis

Abstract
Background

There is concern that delaying treatment for psychosis may have a negative impact on its long-term course. A number of countries have developed early intervention teams but there is limited evidence regarding their cost-effectiveness.

Aims

To compare the costs and cost-effectiveness of an early intervention service in London with standard care.

Method

Individuals in their first episode of psychosis (or those who had previously discontinued treatment) were recruited to the study. Clinical variables and costs were measured at baseline and then at 6- and 18-month follow-up. Information on quality of life and vocational outcomes were combined with costs to assess cost-effectiveness.

Results

A total of 144 people were randomised. Total mean costs were £11 685 in the early intervention group and £14 062 in the standard care group, with the difference not being significant (95% CI –£8128 to £3326). When costs were combined with improved vocational and quality of life outcomes it was shown that early intervention would have a very high likelihood of being cost-effective.

Conclusions

Early intervention did not increase costs and was highly likely to be cost-effective when compared with standard care.

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Copyright
Corresponding author
Correspondence: Paul McCrone, Centre for the Economics of Mental Health, PO 24, Health Service and Population Research Department, David Goldberg Centre, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: p.mccrone@iop.kcl.ac.uk
Footnotes
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See pp. 372–376, this issue.

The study was funded by a grant from the Directorate of Health and Social Care for London R&D Organisation and Management Programme.

Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Cost-effectiveness of an early intervention service for people with psychosis

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eLetters

Cost-utility of EI Services

Ahmed S Huda
Consultant, Early Intervention Team
24 May 2010

In their study the authors found a difference in 6 points in the Manchester Short QOL scale. Is it possible for them to calculate a QALY from their data and hence an incremental cost-effectiveness ratio? It would help give information as to whether EI services are cost-effective in terms of NICE guidelines of about £30k/ QALY. Incidentally, as about 50% of costs of schizhophrenia are "indirect" (e.g. owing to lost productivity) it is heartening to see that even if society is willing to pay nothing for increased employment then EI services are lilkey to be cost effective ... More

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