RESUMO
BACKGROUND: Early intervention programmes (EIPs) in psychosis have gained attention as specialised interventions to improve health-related and societal impacts for people with psychotic disorders. Previous studies have presented evidence in favour of EIPs over the first year of intervention, despite none considering the critical period before psychosis onset (5 years). AIMS: To compare the associated costs of the First Episode Psychosis Intervention Program (CRUPEP) and treatment as usual (TAU) in a real-world cohort in a non-specialised psychiatric community setting. METHOD: Direct and indirect mental health-related costs were calculated over 1 year and up to 7 years. Healthcare and societal costs were calculated from economic data related to the consumption of all healthcare resources, including emergency department attendances, hospital admissions, psychotropic medication prescriptions and societal costs. RESULTS: From a healthcare perspective, the intervention (CRUPEP) group initially showed a marginally higher cost per patient than the TAU group (7621 TAU group v. 11 904 CRUPEP group) over the first year of follow-up. However, this difference was reversed between the groups on considering the entire follow-up, with the TAU group showing considerably higher associated costs per patient (77 026 TAU v. 25 247 CRUPEP). CONCLUSIONS: The EIP (CRUPEP) showed clinical benefits and minimised the direct and indirect health-related costs of the management of psychosis. Although the CRUPEP intervention initially reported increased costs over 1 year, TAU surpassed the global costs over the entire follow-up.
RESUMO
BACKGROUND: The burden of breast cancer is important for the healthcare system. In the context of the evaluation of the breast cancer screening program in the Basque Country it is important to determine the unitary costs related to diagnosis as well as the treatment costs depending on the clinical stage at detection. The main objective was to calculate the total cost and the components of breast cancer (BC) treatment depending on the clinical stage by 2011. METHODS: The estimated costs include BC diagnosis as so as to initial treatment and follow-up, based on resource consumption and unitary costs of the Basque Health Services. Micro-costing technique was applied based on the clinical guidelines. RESULTS: Our model showed the estimated loss of productivity due to premature The initial cost was 9.838 for the stage 0, 17.273 for stage I, 22.145 for stage II and 28.776 for stage III. The follow up annual cost was 172 for the stage 0, 908 for stage I, 994 for stage II and 1.166 for stage III. The annual cost for stage IV was 17879. CONCLUSIONS: Chemotherapy determines the greatest percentage of BC costs. The two main drivers of the total cost of breast cancer are the initial treatment of stages I to III and the cost of stage IV, the latter reaching 50,061 per patient.