Cost-effectiveness analysis in severe mental illness: outcome measures selection.

Area of Science:

• Health Economics
• Psychiatric Research
• Outcome Measurement

Background:

• Economic evaluations in mental healthcare frequently omit preference-based outcomes like Quality-Adjusted Life Years (QALYs).
• Studies often rely on disease-specific measures, potentially limiting comprehensive health assessments.
• This approach may not fully capture the multifaceted impact of treatments in severe mental illness.

Purpose of the Study:

• To highlight challenges in selecting outcome measures for economic studies in severe mental illness.
• To propose strategies for improving future economic evaluations in this field.
• To emphasize the importance of comprehensive outcome measurement for policy decisions.

Main Methods:

• Utilized data from a cost-effectiveness analysis of the Hallucination focused Integrative Treatment (HIT) for schizophrenia.
• Compared economic outcomes based on the Positive and Negative Syndrome Scale (PANSS) with those using QALYs and other health instruments.
• Evaluated results using multiple cost-effectiveness analyses and acceptability curves.

Main Results:

• No significant differences were found using the primary outcome measure (PANSS).
• Significant differences favoring the HIT intervention emerged when using three additional health outcome measures.
• Quality-Adjusted Life Year (QALY) results did not reveal inter-group differences.

Conclusions:

• Outcome measure selection critically impacts economic study results and policy implications in mental healthcare.
• Inconsistent findings across different outcome measures necessitate transparent reporting to decision-makers.
• Until a consensus on preference-based instruments for severe mental illness is reached, Quality of Life (QoL) instruments should complement disease-specific measures.