Early intervention in psychosis: a systematic review of cost-effectiveness studies.
Poster C66, Wednesday, October 10, 11:30 am - 1:00 pm, Essex Ballroom
David Aceituno1,2, Norha Vera1, Matthew Prina1, Paul McCrone1; 1King's College London, 2Pontificia Universidad Católica de Chile
Background Early intervention in psychosis (EIP) has been developed as an approach to improve the prognosis of people with psychotic disorders and has been claimed as a more efficient model of care. However, the evidence is not definitive and doubts have spread regard the economic outcomes of EIP services amid the usually constrained mental health budget. Therefore, we aimed to review the cost-effectiveness evidence of EIP services worldwide. Methods We systematically reviewed the economic literature about EIP following the PRISMA statement guidelines. Studies were selected according to previously stated criteria and analysed using standardised critical appraisal tools for trial-based economic evaluations and modelling studies. Results A total of 16 studies were selected after applying the eligibility criteria. Most of them were economic evaluations within clinical trials. The overall evidence was consistent in the cost-effectiveness of EIP compared to standard care for first-episode of psychosis and prodromal symptoms. Such evidence has been replicated among different health systems, mainly in high-income countries. The methodological quality of such evidence, however, was moderate and there was significant heterogeneity across the studies. Discussion Despite some limitations in the current literature, there is consistent evidence about the value of investing in EIP services. This model of care has demonstrated to be cost-effective, although more research is needed, mainly in low-and-middle countries (LMICs) where some of these services are already being implemented.
Topic Area: Public Policy