Cost-Effectiveness of Positive Memory Training (PoMeT) for the Treatment of Depression in Schizophrenia

Judit Simon (), Noemi Kiss, Kees Korrelboom, David Kingdon, Til Wykes, Peter Phiri, Mark van der Gaag, M. Fazil Baksh and Craig Steel
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Judit Simon: Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Wien, Austria
Noemi Kiss: Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Wien, Austria
Kees Korrelboom: Department of Anxiety Disorders, PsyQ Parnassia Group, Psychiatric Center, Lijnbaan 4, 2512 VA The Hague, The Netherlands
David Kingdon: Department of Psychiatry, Faculty of Medicine, University of Southampton, Highfield, Southampton SO17 1BJ, UK
Til Wykes: Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, UK
Peter Phiri: Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK
Mark van der Gaag: Department of Clinical Psychology, VU University and Amsterdam Public Mental Health Research Institute, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
M. Fazil Baksh: Department of Mathematics and Statistics, University of Reading, Whiteknights, Reading RG6 6AL, UK
Craig Steel: School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights, Reading RG6 6AL, UK

IJERPH, 2022, vol. 19, issue 19, 1-13

Abstract: The Positive Memory Training (PoMeT) trial demonstrated reduced depression symptoms at 3 months for schizophrenia, but its longer-term outcome and cost impacts remain unknown. This study is a within-trial cost-utility analysis with quality-adjusted life years (QALYs) as outcome based on health-related quality of life (HRQoL) measurement and secondary outcome analyses of capability well-being. The incremental cost-effectiveness of PoMeT was compared to Treatment As Usual only (TAU) over 9 months from the ‘health and social’ care and ‘societal’ perspectives. Uncertainty was explored using bootstrapping and sensitivity analyses for cost outliers and outcome methods. HRQoL improvement was observed for both PoMeT and TAU at 3 months, but reached statistical significance and was sustained only for TAU. There was no change in capability well-being and no significant group difference in QALYs gained over 9 months. Mean intervention cost was GBP 823. Compared to TAU, PoMeT had significantly higher mental health care costs (+GBP 1251, 95% CI GBP 185 to GBP 2316) during the trial, but ‘health and social care’ and ‘societal’ cost differences were non-significant. Compared to the before-trial period, psychiatric medication costs increased significantly in both groups. The probability of PoMeT being cost-effective in the given format over 9 months was <30% and decreased further in sensitivity analyses.. Generalizability remains limited since the before-after cost analysis revealed additional treatment effects also in the TAU group that likely diminished the incremental impacts and cost-effectiveness of PoMeT. It is not clear whether an active post-intervention follow-up could result in sustained longer-term effects and improved cost-effectiveness.

Keywords: cognitive therapy; schizophrenia; economic evaluation; cost-effectiveness; quality of life; capabilities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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