Value of schizophrenia treatment II: Decision modelling for developing early detection and early intervention services in the Czech Republic

Petr Winkler, Hana Marie Broulíková, Lucie Kondrátová, Martin Knapp, Paul Arteel, Patrice Boyer, Silvana Galderisi, Hikka Karkkainen, Aagje Ieven, Pavel Mohr, Danuta Wasserman, A-La Park, Michella Tinelli, Wolfgang Gaebel

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Positive findings on early detection and early intervention services have been consistently reported from many different countries. The aim of this study, conducted within the European Brain Council project “The Value of Treatment”, was to estimate costs and the potential cost- savings associated with adopting these services within the context of the Czech mental health care reform.

Methods
Czech epidemiological data, probabilities derived from meta-analyses, and data on costs of mental health services in the Czech Republic were used to populate a decision analytical model. From the health care and societal perspectives, costs associated with health care services and productivity lost were taken into account. One-way sensitivity analyses were conducted to explore the uncertainty around the key parameters.

Results
It was estimated that annual costs associated with care as usual for people with the first episode of psychosis were as high as 46 million Euro in the Czech Republic 2016. These annual costs could be reduced by 25% if ED services were adopted, 33% if EI services were adopted, and 40% if both, ED and EI services, were adopted in the country. Cost-savings would be generated due to decreased hospitalisations and better employment outcomes in people with psychoses.

Conclusions
Adopting early detection and early intervention services in mental health systems based on psychiatric hospitals and with limited access to acute and community care could generate considerable cost- savings. Although the results of this modelling study needs to be taken with caution, early detection and early intervention services are recommended for multi-centre pilot testing accompanied by full economic evaluation in the region of Central and Eastern Europe.
Original languageEnglish
Pages (from-to)116-122
Number of pages7
JournalEuropean Psychiatry
Volume53
Early online date20 Jul 2018
DOIs
Publication statusPublished - Sept 2018

Keywords

  • Schizophrenia
  • Psychosis
  • Early detection
  • Early intervention
  • Health economics

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