Cost-effectiveness of an improving access to psychological therapies service

Br J Psychiatry. 2013 Mar;202(3):220-7. doi: 10.1192/bjp.bp.111.107888. Epub 2013 Jan 10.

Abstract

Background: Effective psychological therapies have been recommended for common mental health problems, such as depression and anxiety, but provision has been poor. Improving Access to Psychological Therapies (IAPT) may provide a cost-effective solution to this problem.

Aims: To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007-2009).

Method: An economic evaluation comparing costs and health outcomes for patients at the IAPT demonstration site with those for comparator sites, including a separate assessment of lost productivity. Sensitivity analyses were undertaken.

Results: The IAPT site had higher service costs and was associated with small additional gains in quality-adjusted life-years (QALYs) compared with its comparator sites, resulting in a cost per QALY gained of £29 500 using the Short Form (SF-6D). Sensitivity analysis using predicted EQ-5D scores lowered this to £16 857. Costs per reliable and clinically significant (RCS) improvement were £9440 per participant.

Conclusions: Improving Access to Psychological Therapies provided a service that was probably cost-effective within the usual National Institute for Health and Clinical Excellence (NICE) threshold range of £20 000-30 000, but there was considerable uncertainty surrounding the costs and outcome differences.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / therapy*
  • Cognitive Behavioral Therapy / economics
  • Combined Modality Therapy / economics
  • Combined Modality Therapy / statistics & numerical data
  • Cost-Benefit Analysis
  • Depression / therapy*
  • Family Practice
  • Female
  • Guidelines as Topic
  • Health Care Costs*
  • Health Services Accessibility / economics*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / economics
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Patient Dropouts
  • Program Evaluation
  • Psychotherapy / economics
  • Psychotherapy / organization & administration*
  • Quality Assurance, Health Care / economics
  • Quality-Adjusted Life Years
  • State Medicine / organization & administration
  • United Kingdom
  • Young Adult