Economic evaluation of intensive home treatment in comparison to care as usual alongside a randomised controlled trial

Ansam Barakat (), Jurgen E. Cornelis, Jack J. M. Dekker, Nick M. Lommerse, Aartjan T. F. Beekman and Matthijs Blankers
Additional contact information
Ansam Barakat: Amsterdam Public Health Research Institute Amsterdam UMC
Jurgen E. Cornelis: Arkin Institute for Mental Health Care
Jack J. M. Dekker: Arkin Institute for Mental Health Care
Nick M. Lommerse: Arkin Institute for Mental Health Care
Aartjan T. F. Beekman: Amsterdam Public Health Research Institute Amsterdam UMC
Matthijs Blankers: Arkin Institute for Mental Health Care

The European Journal of Health Economics, 2025, vol. 26, issue 1, No 3, 23-34

Abstract: Abstract Background There is a dearth of research on the cost-effectiveness of intensive home treatment (IHT), an alternative to psychiatric hospitalisation for patients experiencing psychiatric crises. We therefore present a health economic evaluation alongside a pre-randomised controlled trial of IHT compared to care as usual (CAU). Method Patients were pre-randomised to IHT or CAU using a double-consent open-label Zelen design. For the cost-utility analysis, the EuroQol 5-dimensional instrument was used. The cost-effectiveness was assessed using the Brief Psychiatric Rating Scale (BPRS). Results Data of 198 patients showed that each additional QALY gained from offering IHT instead of CAU was on average associated with an extra cost of €48,003. There is a 38% likelihood that IHT will lead to more QALYs at lower costs compared to CAU. An improvement of one additional point on the BPRS by offering IHT instead of CAU was associated with an extra cost of €19,203. There is a 38% likelihood that IHT will lead to higher BPRS score improvements at lower costs. Based on the NICE willingness-to-pay threshold of £30,000 (€35,000) per QALY, IHT could potentially be considered cost-effective with a likelihood of 55–60% when viewed from a societal perspective, and > 75% from a health care perspective. Conclusions IHT appears slightly more attractive in terms of cost-utility and cost-effectiveness than CAU, although differences in both costs and effects are small especially when viewed from the societal costs perspective. From the health care sector costs perspective, IHT has a higher probability of being cost-effective compared to CAU. Trials registration Netherlands Trial Register: NTR6151.

Keywords: Economic evaluation; Intensive home treatment; Emergency psychiatry; Pre-randomised controlled trial (search for similar items in EconPapers)
JEL-codes: H12 I18 (search for similar items in EconPapers)
Date: 2025
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10198-024-01675-1 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:eujhec:v:26:y:2025:i:1:d:10.1007_s10198-024-01675-1

Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2

DOI: 10.1007/s10198-024-01675-1

Access Statistics for this article

The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().