Access Restriction

Author Mendis, Nalaka ♦ F. Jose-Luis Ayuso-Mateos, G. ♦ Shekhar Saxena, H.
Source CiteSeerX
Content type Text
File Format PDF
Subject Domain (in DDC) Computer science, information & general works ♦ Data processing & computer science
Subject Keyword Multinational Cost-effectiveness Analysis ♦ Developing World ♦ Schizophrenia Treatment ♦ Disability-adjusted Life Year ♦ Cost-effective Intervention ♦ Antipsychotic Drug ♦ Community-based Service Model ♦ Disease Severity ♦ Method Analysis ♦ Member State ♦ Total Population-level Cost ♦ Treatment Coverage ♦ Atypical Antipsychotic Drug ♦ Priority-setting Criterion ♦ Cost-effectiveness Ratio ♦ Human Right Protection ♦ Objective Schizophrenia ♦ Relative Cost-effectiveness ♦ Psychosocial Intervention ♦ Population-level Health Impact ♦ Great Deal ♦ State Transition Model ♦ Country-level Contextualisation ♦ Disabling Disease ♦ Psychosocial Treatment ♦ Local Currency ♦ International Dollar ♦ Sri Lanka ♦ South-east Asia ♦ Efficient Treatment Option
Abstract Objective Schizophrenia is a highly disabling disease and is costly to treat. We set out to establish what are the most cost-effective interventions applicable to developing regions and countries. Methods Analysis was undertaken at the level of three WHO subregions spanning the Americas, Africa and South-East Asia, and subsequently in three member states (Chile, Nigeria and Sri Lanka). A state transition model was used to estimate the population-level health impact of older and newer antipsychotic drugs, alone or in combination with psychosocial intervention. Total population-level costs (in international dollars or local currencies) and effectiveness (measured in disability-adjusted life years averted) were combined to form cost-effectiveness ratios. Findings The most cost-effective interventions were those using older antipsychotic drugs combined with psychosocial treatment, delivered via a community-based service model (I $ 2350–7158 per disability-adjusted life year averted across the three subregions, I $ 1670–3400 following country-level contextualisation within each of these subregions). The relative cost-effectiveness of interventions making use of newer, “atypical ” antipsychotic drugs is estimated to be much less favourable. Conclusion By moving to a community-based service model and selecting efficient treatment options, the cost of substantially increasing treatment coverage is not high (less than I $ 1 investment per capita). Taken together with other priority-setting criteria such as disease severity, vulnerability and human rights protection, this study suggests that a great deal more could be done for persons and families living under the spectre of this disorder.
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Research
Education Level UG and PG ♦ Career/Technical Study
Publisher Date 2008-01-01