First-episode psychosis intervention programme versus standard care for the clinical management of early phases of psychosis: cost analysis
Oliver Ibarrondo,
María Recio-Barbero,
Iker Ustarroz,
Janire Cabezas-Garduño,
Oihane Mentxaka,
Teresa Acaiturri,
Elisa Gómez,
Rafael Segarra
Affiliations
Oliver Ibarrondo
RS-Statistics, Arrasate-Mondragón, Gipuzkoa, Spain; and Research Unit, Debagoiena Integrated Healthcare Organisation, Basque Health Service (Osakidetza), Arrasate-Mondragón, Guipúzcoa, Spain
Early Stages of Psychosis Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Biscay, Spain; and Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Biscay, Spain
Iker Ustarroz
Economic-Financial Directorate, Cruces University Hospital, Barakaldo, Biscay, Spain
Janire Cabezas-Garduño
Early Stages of Psychosis Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Biscay, Spain; and Department of Psychiatry, Cruces University Hospital, Barakaldo, Biscay, Spain
Oihane Mentxaka
Early Stages of Psychosis Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Biscay, Spain; Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Biscay, Spain; and Department of Psychiatry, Cruces University Hospital, Barakaldo, Biscay, Spain
Teresa Acaiturri
Economic-Financial Directorate, Cruces University Hospital, Barakaldo, Biscay, Spain
Elisa Gómez
Economic-Financial Directorate, Cruces University Hospital, Barakaldo, Biscay, Spain
Rafael Segarra
Early Stages of Psychosis Group, Biocruces Bizkaia Health Research Institute, Barakaldo, Biscay, Spain; Department of Neurosciences, University of the Basque Country (UPV/EHU), Leioa, Biscay, Spain; Department of Psychiatry, Cruces University Hospital, Barakaldo, Biscay, Spain; and Centre for Biomedical Research in Mental Health, Carlos III Institute of Health (CIBERSAM ISCIII), Leioa, Biscay, Spain
Background Early intervention programmes (EIPs) in psychosis have gained attention as specialised interventions to improve health-related and societal impacts for people with psychotic disorders. Previous studies have presented evidence in favour of EIPs over the first year of intervention, despite none considering the critical period before psychosis onset (5 years). Aims To compare the associated costs of the First Episode Psychosis Intervention Program (CRUPEP) and treatment as usual (TAU) in a real-world cohort in a non-specialised psychiatric community setting. Method Direct and indirect mental health-related costs were calculated over 1 year and up to 7 years. Healthcare and societal costs were calculated from economic data related to the consumption of all healthcare resources, including emergency department attendances, hospital admissions, psychotropic medication prescriptions and societal costs. Results From a healthcare perspective, the intervention (CRUPEP) group initially showed a marginally higher cost per patient than the TAU group (€7621 TAU group v. €11 904 CRUPEP group) over the first year of follow-up. However, this difference was reversed between the groups on considering the entire follow-up, with the TAU group showing considerably higher associated costs per patient (€77 026 TAU v. €25 247 CRUPEP). Conclusions The EIP (CRUPEP) showed clinical benefits and minimised the direct and indirect health-related costs of the management of psychosis. Although the CRUPEP intervention initially reported increased costs over 1 year, TAU surpassed the global costs over the entire follow-up.
