Shared sorrow, shared costs: cost-effectiveness analysis of the Empowerment group therapy approach to treat affective disorders in refugee populations.
BJPsych Open
; 9(4): e113, 2023 Jun 22.
Article
en En
| MEDLINE
| ID: mdl-37345544
ABSTRACT
BACKGROUND:
Refugees and asylum seekers (RAS) in Germany need tailored and resource-oriented mental healthcare interventions.AIMS:
To evaluate the cost-effectiveness of group psychotherapy for RAS with moderate depressive symptoms.METHOD:
This is a post hoc cost-effectiveness analysis of Empowerment group psychotherapy that was embedded in a stratified stepped and collaborative care model (SCCM) from the multicentre randomised controlled MEHIRA trial. One hundred and forty-nine participants were randomly assigned to SCCM or treatment as usual (TAU) and underwent Empowerment (i.e. level 3 of the SCCM for adults) or TAU. Effects were measured with the nine-item Patient Health Questionnaire (PHQ-9) and quality adjusted life-years (QALY) post-intervention. Health service and intervention costs were measured. Incremental cost-effectiveness ratios (ICER) were estimated and net monetary benefit (NMB) regressions with 95% confidence intervals were performed. Cost-effectiveness was ascertained for different values of willingness to pay (WTP) using cost-effectiveness acceptability curves for probable scenarios. Trial registration number NCT03109028 on ClinicalTrials.gov.RESULTS:
Health service use costs were significantly lower for Empowerment than TAU after 1 year. Intervention costs were on average 409.6. Empowerment led to a significant change in PHQ-9 scores but not QALY. Bootstrapped mean ICER indicated cost-effectiveness according to PHQ-9 and varied considerably for QALY in the base case. NMB for a unit reduction in PHQ-9 score at WTP of 0 was 354.3 (978.5 to -269.9). Results were confirmed for different scenarios and varying WTP thresholds.CONCLUSIONS:
The Empowerment intervention was cost-effective in refugees with moderate depressive symptoms regarding the clinical outcome and led to a reduction in direct healthcare consumption. Concerning QALYs, there was a lack of confidence that Empowerment differed from TAU.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Patient_preference
Idioma:
En
Revista:
BJPsych Open
Año:
2023
Tipo del documento:
Article
País de afiliación:
Alemania