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Developing a Health-Economic Model to Assess Cost-Effectiveness of Preventive Interventions for Children of Parents

Yara M Meijer1, Ben F M Wijnen2, Anne Kleijburg3

  • 1Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands; Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|February 4, 2026
PubMed

Insights

Preventive group-based cognitive behavioral therapy (CBT) for children of parents with mental illness (COPMI) is a cost-effective strategy. This intervention shows a high probability of being cost-effective, supporting mental health care decisions.

Area of Science:

  • Public Health
  • Mental Health Economics
  • Preventive Medicine

Background:

  • Children of parents with mental illness (COPMI) have an elevated risk of developing mental health disorders.
  • Existing preventive interventions for COPMI lack comprehensive cost-effectiveness analyses and long-term outcome modeling.
  • Societal and healthcare costs associated with untreated mental disorders in COPMI are substantial.

Purpose of the Study:

  • To develop and apply a Markov model for evaluating the cost-effectiveness of preventive interventions targeting COPMI in the Netherlands.
  • To simulate long-term health and economic outcomes for COPMI from healthcare and societal perspectives.
  • To assess the cost-utility of a group-based cognitive behavioral therapy (CBT) intervention for COPMI.

Main Methods:

  • A decision-analytic Markov model was constructed using data from the Avon Longitudinal Study of Parents and Children.
  • The model simulates COPMI progression through health states (healthy, depression/anxiety, comorbidity, remission, death) over a 28-year period (ages 7-35).
  • Cost-effectiveness was evaluated using quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs), comparing group CBT to a reference scenario.

Main Results:

  • The group-based CBT intervention resulted in an additional 0.02 QALYs at an incremental cost of €188 per patient.
  • The incremental cost-effectiveness ratio (ICER) was calculated at €9,495 per QALY.
  • There was a 74% probability that the CBT intervention would be cost-effective at a willingness-to-pay threshold of €20,000 per QALY.

Conclusions:

  • The developed Markov model offers a flexible framework for assessing the cost-utility of various COPMI interventions.
  • Group-based cognitive behavioral therapy (CBT) appears to be a potentially cost-effective strategy for preventing mental disorders in children of parents with mental illness.
  • The model is available for academic use to aid informed decision-making in mental health care for COPMI.
Abstract

Keywords:
ALSPACCOPMIanxietycost-effectivenessdepression

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