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Cognitive Behavioral Therapy in Early Intervention for Psychosis: A Cost-Effectiveness Analysis
Maximilian Duckworth1, Sofia Venturini2,3, Andres Roman-Urrestarazu1
1Department of Psychiatry University of Cambridge, Cambridge, UK.
Journal of Health Economics and Outcomes Research
|June 15, 2026
Summary
Cognitive behavioral therapy for psychosis (CBTp) added to pharmacotherapy in early intervention for psychosis (EIP) offers marginal cost-effectiveness. Further research and targeted implementation are recommended to clarify its value for money.
Area of Science:
- Psychiatry
- Health Economics
- Health Services Research
Background:
- Early intervention for psychosis (EIP) services integrate pharmacotherapy and CBTp for early psychosis.
- The individual cost-effectiveness of CBTp within EIP is not well-established.
- Understanding the value of EIP components is vital due to funding pressures.
Purpose of the Study:
- To assess the cost-effectiveness of CBTp combined with pharmacotherapy versus pharmacotherapy alone in EIP.
- To inform resource allocation decisions in mental health services.
Main Methods:
- A societal perspective cost-effectiveness analysis using a 3-year Markov model.
- Model parameters were sourced from a literature review.
- Primary outcome: incremental cost-effectiveness ratio (ICER) per QALY gained; sensitivity analyses (one-way and probabilistic) were performed.
Main Results:
- CBTp adjunct to pharmacotherapy yielded 0.48 QALYs gain with an ICER of £32,979/QALY.
- The ICER exceeded the £30,000/QALY willingness-to-pay threshold.
- Probabilistic sensitivity analysis indicated a ~50% probability of cost-effectiveness at the £30,000 threshold.
Conclusions:
- Parameter uncertainty, especially in costs and utilities, influences the marginal cost-effectiveness of CBTp.
- CBTp may be cost-effective with targeted improvements in delivery or patient selection.
- Further long-term studies are needed to strengthen evidence for CBTp in EIP.
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