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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.
Feng, Y; Roukas, C; Russo, M; Repisti, S; Dzubur Kulenovic, A; Injac Stevovic, L; Konjufca, J; Markovska-Simoska, S; Novotni, L; Ristic, I; Smajic-Mesevic, E; Uka, F; Zebic, M; Voncina, L; Bobinac, A; Jovanovic, N.
  • Feng Y; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
  • Roukas C; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
  • Russo M; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
  • Repisti S; Psychiatric Clinic, Clinical Centre of Montenegro, Podgorica, Montenegro.
  • Dzubur Kulenovic A; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
  • Injac Stevovic L; Department of Psychology, University of Pristina, Pristina, Kosovo by United Nations Resolution.
  • Konjufca J; Department of Psychology, University of Pristina, Pristina, Kosovo by United Nations Resolution.
  • Markovska-Simoska S; Macedonian Academy of Sciences and Arts, Skopje, Republic of North Macedonia.
  • Novotni L; University Clinic of Psychiatry, Skopje, Republic of North Macedonia.
  • Ristic I; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
  • Smajic-Mesevic E; Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
  • Uka F; Department of Psychology, University of Pristina, Pristina, Kosovo by United Nations Resolution.
  • Zebic M; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
  • Voncina L; Faculty of health studies, University of Rijeka, Rijeka, Croatia.
  • Bobinac A; Center for Health Economics and Pharmacoeconomics, Faculty of Economics and Business, University of Rijeka, Rijeka, Croatia.
  • Jovanovic N; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Eur Psychiatry ; 65(1): e56, 2022 08 26.
Article in English | MEDLINE | ID: covidwho-2054015
ABSTRACT

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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%.

CONCLUSION:

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychotic Disorders / COVID-19 Type of study: Experimental Studies / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur Psychiatry Journal subject: Psychiatry Year: 2022 Document Type: Article Affiliation country: J.eurpsy.2022.2310

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Psychotic Disorders / COVID-19 Type of study: Experimental Studies / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Eur Psychiatry Journal subject: Psychiatry Year: 2022 Document Type: Article Affiliation country: J.eurpsy.2022.2310