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Risk stratification for treating people at ultra-high risk for psychosis: A cost-effectiveness analysis.
- Source :
-
Schizophrenia Research . Nov2023, Vol. 261, p225-233. 9p. - Publication Year :
- 2023
-
Abstract
- People who are at ultra-high risk (UHR) for psychosis receive clinical care with the aim to prevent first-episode psychosis (FEP), regardless of the risk of conversion to psychosis. An economic model from the Canadian health system perspective was developed to evaluate the cost-effectiveness of treating all with UHR compared to risk stratification over a 15-year time horizon, based on conversion probability, expected quality-of-life and costs. The analysis used a decision tree followed by a Markov model. Health states included: Not UHR, UHR with <20 % risk of conversion to FEP (based on the North American Prodrome Longitudinal Study risk calculator), UHR with ≥20 % risk, FEP, Remission, Post-FEP, and Death. The analysis found that: risk stratification (i.e., only treating those with ≥20 % risk) had lower costs ($1398) and quality-adjusted life-years (0.055 QALYs) per person compared to treating all. The incremental cost-effectiveness ratio for 'treat all' was $25,448/QALY, and suggests treating all may be cost-effective. The model was sensitive to changes to the probability of conversion. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09209964
- Volume :
- 261
- Database :
- Academic Search Index
- Journal :
- Schizophrenia Research
- Publication Type :
- Academic Journal
- Accession number :
- 173473457
- Full Text :
- https://doi.org/10.1016/j.schres.2023.09.015