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Feng, Y.; Roukas, C.; Russo, M.; Repišti, S.; Džubur Kulenović, A.; Injac Stevović, L.; Konjufca, J.; Markovska-Simoska, S.; Novotni, L.; Ristić, I.; Smajić-Mešević, E.; Uka, F.; Zebić, M.; Vončina, L.; Bobinac, A.; Jovanović, N.

Cost-effectiveness of implementing a digital psychosocial intervention for patients with psychotic spectrum disorders in low- and middle-income countries in Southeast Europe: Economic evaluation alongside a cluster randomised trial

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  • Media type: E-Article
  • Title: Cost-effectiveness of implementing a digital psychosocial intervention for patients with psychotic spectrum disorders in low- and middle-income countries in Southeast Europe: Economic evaluation alongside a cluster randomised trial
  • Contributor: Feng, Y.; Roukas, C.; Russo, M.; Repišti, S.; Džubur Kulenović, A.; Injac Stevović, L.; Konjufca, J.; Markovska-Simoska, S.; Novotni, L.; Ristić, I.; Smajić-Mešević, E.; Uka, F.; Zebić, M.; Vončina, L.; Bobinac, A.; Jovanović, N.
  • imprint: Royal College of Psychiatrists, 2022
  • Published in: European Psychiatry
  • Language: English
  • DOI: 10.1192/j.eurpsy.2022.2310
  • ISSN: 0924-9338; 1778-3585
  • Keywords: Psychiatry and Mental health
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec id="S0924933822023100_sec1"> <jats:title>Background</jats:title> <jats:p>DIALOG+ is a digital psychosocial intervention aimed at making routine meetings between patients and clinicians therapeutically effective. This study aimed to evaluate the cost-effectiveness of implementing DIALOG+ treatment for patients with psychotic disorders in five low- and middle-income countries in Southeast Europe alongside a cluster randomised trial.</jats:p> </jats:sec> <jats:sec id="S0924933822023100_sec2" sec-type="methods"> <jats:title>Methods</jats:title> <jats:p>Resource use and quality of life data were collected alongside the multi-country cluster randomised trial of 468 participants with psychotic disorders. Due to COVID-19 interruptions of the trial’s original 12-month intervention period, adjusted costs and quality-adjusted life years (QALYs) were estimated at the participant level using a mixed-effects model over the first 6 months only. We estimated the incremental cost-effectiveness ratio (ICER) with uncertainty presented using a cost-effectiveness plane and a cost-effectiveness acceptability curve. Seven sensitivity analyses were conducted to check the robustness of the findings.</jats:p> </jats:sec> <jats:sec id="S0924933822023100_sec3" sec-type="results"> <jats:title>Results</jats:title> <jats:p>The average cost of delivering DIALOG+ was €91.11 per participant. DIALOG+ was associated with an incremental health gain of 0.0032 QALYs (95% CI –0.0015, 0.0079), incremental costs of €84.17 (95% CI –8.18, 176.52), and an estimated ICER of €26,347.61. The probability of DIALOG+ being cost-effective against three times the weighted gross domestic product (GDP) per capita for the five participating countries was 18.9%.</jats:p> </jats:sec> <jats:sec id="S0924933822023100_sec4" sec-type="conclusions"> <jats:title>Conclusion</jats:title> <jats:p>Evidence from the cost-effectiveness analyses in this study suggested that DIALOG+ involved relatively low costs. However, it is not likely to be cost-effective in the five participating countries compared with standard care against a willingness-to-pay threshold of three times the weighted GDP per capita per QALY gained.</jats:p> </jats:sec>
  • Access State: Open Access