Examining Psychologist Prescriptive Authority as a Cost-Effective Strategy for Reducing Suicide Rates

Area of Science:

• Health Economics
• Public Health Policy
• Mental Healthcare

Background:

• Six U.S. states (NM, LA, IL, IA, ID, CO) permit qualified psychologists to prescribe medication.
• Prior research indicates these policies correlate with decreased suicide rates.
• The economic impact of these policies on suicide reduction remains under-examined.

Purpose of the Study:

• To evaluate the cost-effectiveness of psychologist prescribing authority in reducing suicide rates.
• To quantify the Incremental Net Monetary Benefit (INMB) of this policy over a 20-year period.
• To determine the probability of cost-effectiveness at various willingness-to-pay thresholds.

Main Methods:

• A 20-year Markov Model was employed for simulation.
• A societal perspective was adopted, modeling a cohort of 100,000 individuals.
• Transition probabilities and utilities were sourced from existing literature; costs were determined via a mixed macro-micro approach.

Main Results:

• The 20-year INMB was estimated at $12.81 million USD per Quality-Adjusted Life Year (QALY).
• Cost-effectiveness probability exceeded 50% with a willingness-to-pay threshold as low as $10,000 per QALY.
• Model sensitivity analyses indicated modest influence of implementation costs but significant sensitivity to the policy's intervention effect.

Conclusions:

• Psychologist prescribing authority represents a cost-effective intervention for lowering state-level suicide rates.
• The policy shows strong economic justification, particularly at lower willingness-to-pay thresholds.
• Further research is necessary to elucidate the policy's impact with greater precision and granularity.