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Utilising survey data to inform public policy: Comparison of the cost-effectiveness of treatment of ten mental disorders

  • Gavin Andrews (a1), Cathy Issakidis (a2), Kristy Sanderson (a3), Justine Corry (a4) and Helen Lapsley (a4)...
Abstract
Background

Mental health survey data are now being used proactively to decide how the burden of disease might best be reduced.

Aims

To study the cost-effectiveness of current and optimal treatments for mental disorders and the proportion of burden avertable by each.

Method

Data for three affective, four anxiety and two alcohol use disorders and for schizophrenia were compared in terms of cost, burden averted and efficiency of current and optimal treatment. We then calculated the burden unavertable given current knowledge. The unit of health gain was a reduction in the years lived with disability (YLDs).

Results

Summing across all disorders, current treatment averted 13% of the burden, at an average cost of AUS$30 000 per YLD gained. Optimal treatment at current coverage could avert 20% of the burden, at an average cost of AUS$18 000 per YLD gained. Optimal treatment at optimal coverage could avert 28% of the burden, at AUS$16 000 per YLD gained. Sixty per cent of the burden of mental disorders was deemed to be unavertable.

Conclusions

The efficiency of treatment varied more than tenfold across disorders. Although coverage of some of the more efficient treatments should be extended, other factors justify continued use of less-efficient treatments for some disorders.

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Copyright
Corresponding author
Professor Gavin Andrews, 299 Forbes Street, Darlinghurst, NSW 2010, Australia. Fax: + 612 9332 4316; e-mail: gavina@unsw.edu.au
Footnotes
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Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes
References
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Andrews, G. (1999) Randomised controlled trials in psychiatry. BMJ, 319, 562564.
Andrews, G., Hall, W., Goldstein, G., et al (1985) The economic costs of schizophrenia. Archives of General Psychiatry, 42, 537543.
Andrews, G., Sanderson, K., Corry, J., et al (2000) Using epidemiological data to model efficiency in reducing the burden of depression. Journal of Mental Health Policy and Economics, 3, 175186.
Andrews, G., Henderson, S. & Hall, W. (2001) Prevalence, comorbidity, disability and service utilisation. Overview of the Australian Mental Health Survey. British Journal of Psychiatry, 178, 145153.
Andrews, G., Slade, T. & Issakidis, C. (2002) Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being. British Journal of Psychiatry, 181, 306314.
Andrews, G., Sanderson, K., Corry, J., et al (2003a) Cost-effectiveness of current and optimal treatment for schizophrenia. British Journal of Psychiatry, 183, 427435.
Andrews, G., Oakley-Browne, M., Castle, D., et al (2003b) Summary of guidelines for the treatment of panic disorder and agoraphobia. Australasian Psychiatry, 11, 2933.
Andrews, G., Craemer, M., Crino, R., et al (2003c) The Treatment of Anxiety Disorders: Clinician's Guide and Patient Manuals (2nd edn). Cambridge: Cambridge University Press.
Callahan, D. (1995) Setting mental health priorities. In What Price Mental Health? (eds Boyle, P. J. & Callahan, D.), pp. 175192. Washington, DC: Georgetown University Press.
Calman, K. C. (1994) The ethics of allocation of scarce health resources. Journal of Medical Ethics, 20, 7174.
Corry, J., Sanderson, K., Issakidis, C., et al (2004) Evidence-based care for alcohol use disorders is affordable. Journal of Studies on Alcohol, in press.
Ellis, P. M., Hickie, I. H. & Smith, D. A. R. (2003) Summary of guidelines for the treatment of depression. Australasian Psychiatry, 11, 3438.
Foa, E. B., Keane, T. M. & Friedman, M. J. (2000) Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. New York: The Guilford Press.
Gold, M. R., Siegel, J. E., Russell, L. B., et al (1996) Cost-effectiveness in Health and Medicine. New York: Oxford University Press.
Goldberg, D. (2003) Invited commentary on: Cost-effectiveness of current and optimal treatment for schizophrenia. British Journal of Psychiatry, 183, 436.
Haby, M., Carter, R., Mihalopolous, C., et al (2004) Assessing cost effectiveness in mental health. Australian and New Zealand Journal of Psychiatry in press.
Hatziandreu, E. J., Brown, R. E., Revicki, D. A., et al (1994) Cost utility of maintenance treatment of recurrent depression with sertraline versus episodic treatment with dothiepin. Pharmaco Economics, 5, 249268.
Issakidis, C., Sanderson, K., Corry, J., et al (2004) Modelling the population cost-effectiveness of current and evidence based optimal treatment for anxiety disorders. Psychological Medicine, 34, 117.
Jablensky, A., McGrath, J., Herrman, H., et al (2000) Psychotic disorders in urban areas: an overview of the study of low prevalence disorders. Australian and New Zealand Journal of Psychiatry, 34, 221236.
Jack, W. (2000) Public spending on health care: how are different criteria related? A second opinion. Health Policy, 53, 6167.
Kessler, R. C. (1999) The World Health Organization International Consortium in Psychiatric Epidemiology. Acta Psychiatrica Scandinavica, 99, 29
Lehman, A. F. & Steinwachs, D. M. (1998) Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophrenia Bulletin, 24, 110.
Lonnqvist, J., Sintonen, H., Syvalahti, E., et al (1994) Antidepressant efficacy and quality of life in depression: a double blind study with moclobemide and fluoxetine. Acta Psychiatrica Scandinavica, 89, 363369.
Manderscheid, R. W., Rae, D. S., Narrow, W. E., et al (1993) Congruence of service utilisation estimates from the Epidemiologic Catchment Area Project and other sources. Archives of General Psychiatry, 50, 108114.
Mathers, C., Vos, T. & Stevenson, C. (1999) The Burden of Disease and Injury in Australia. AIHW cat. No. PHE17. Canberra: AIHW.
Maynard, A. (1999) Rationing health care: an exploration. Health Policy, 49, 511.
Moyer, A., Finney, J. W., Swearingen, C. E., et al (2002) Brief interventions for alcohol problems. Addiction, 97, 279292.
Murray, C. J. & Lopez, A. D. (1996) The Global Burden of Disease: a Comprehensive Assessment of Mortality and Disability from Disease, Injuries and Risk Factors in 1990 and Projected to 2020. Cambridge, MA: Harvard University Press.
Musgrove, P. (1999) Public spending on health care: how are different criteria related? Health Policy, 47, 207223.
Nathan, P. E. & Gorman, J. N. (2002) AGuideto Treatments that Work. New York: Oxford University Press.
Ormel, J., Von Korff, M., Van den Brink, W., et al (1993) Depression, anxiety and social disability show synchrony of change in primary care patients. American Journal of Public Health, 83, 385390.
Proudfoot, H. & Teesson, M. (2002) Who seeks treatment for alcohol dependence? Social Psychiatry and Psychiatric Epidemiology, 37, 451456.
Rosenheck, R. A. (1999) Principles for priority setting in mental health services and their implications for the least well off. Psychiatric Services, 50, 653658.
Sanderson, K., Andrews, G., Corry, J., et al (2003) Reducing the burden of affective disorders: is evidence based health care affordable? Journal of Affective Disorders, 77, 109125.
Sanderson, K., Andrews, G., Corry, J., et al (2004) Using the effect size to model changes in preference values form descriptive health status. Quality of Life Research, in press.
Warner, R. (2003) How much of the burden of schizophrenia is alleviated by treatment? British Journal of Psychiatry, 183, 375376.
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Utilising survey data to inform public policy: Comparison of the cost-effectiveness of treatment of ten mental disorders

  • Gavin Andrews (a1), Cathy Issakidis (a2), Kristy Sanderson (a3), Justine Corry (a4) and Helen Lapsley (a4)...
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