Background:
Recent research has shown that the provision of specific treatment to young people identified as being at ‘ultrahigh risk’ (UHR) of developing a psychotic disorder may delay, or even prevent, the onset of disorder. However, there are obvious costs associated with identifying and treating UHR individuals and whether such intervention provides value for money is important in the context of scarce health resources. This study aimed to determine the health sector costs associated with a randomized controlled trial for UHR participants attending the PACE Clinic in Melbourne, Australia. A second aim was to determine whether specific preventive intervention (SPI) resulted in cost savings over short (12 months) and long (12-36 month) follow-up periods.
Methods:
Treatment was either an SPI (neuroleptic medication and cognitively oriented psychotherapy) or needs-based intervention (NBI; supportive psychotherapy alone).
Results:
During the treatment phase, the SPI group incurred significantly higher therapy and total costs compared with the NBI group, but hospital and medication costs did not differ between the groups. There were no significant treatment cost differences between the SPI and NBI groups over the first follow-up phase. However, over the second follow-up phase, the SPI group incurred significantly lower therapy and total costs. Members of the NBI group who did not develop psychosis incurred significantly higher therapy and total costs compared with the SPI subgroup members who did not develop psychosis. There were no significant cost differences in treatment of the psychotic subgroups of the NBI and SPI groups over the long-term follow-up period.
Conclusion:
This preliminary study has shown the long-term cost savings associated with specific treatment for young people at UHR for psychosis.
