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Assessing Cost-Effectiveness - Mental Health: introduction to the study and methods

Michelle M. Haby · Rob Carter · Cathrine Mihalopoulos · Anne Magnus · Kristy A. Sanderson · Gavin Andrews +1 more

62 citations0/0 files storedAustralian & New Zealand Journal of Psychiatry

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Health Systems, Economic Evaluations, Quality of Life Psychiatric care and mental health services Mental Health Treatment and Access

Abstract

OBJECTIVE: The Assessing Cost-Effectiveness - Mental Health (ACE-MH) study aims to assess from a health sector perspective, whether there are options for change that could improve the effectiveness and efficiency of Australia's current mental health services by directing available resources toward "best practice" cost-effective services. METHOD: The use of standardized evaluation methods addresses the reservations expressed by many economists about the simplistic use of League Tables based on economic studies confounded by differences in methods, context and setting. The cost-effectiveness ratio for each intervention is calculated using economic and epidemiological data. This includes systematic reviews and randomised controlled trials for efficacy, the Australian Surveys of Mental Health and Wellbeing for current practice and a combination of trials and longitudinal studies for adherence. The cost-effectiveness ratios are presented as cost (A$) per disability-adjusted life year (DALY) saved with a 95% uncertainty interval based on Monte Carlo simulation modelling. An assessment of interventions on "second filter" criteria ("equity", "strength of evidence", "feasibility" and "acceptability to stakeholders") allows broader concepts of 'benefit' to be taken into account, as well as factors that might influence policy judgements in addition to cost-effectiveness ratios. CONCLUSIONS: The main limitation of the study is in the translation of the effect size from trials into a change in the DALY disability weight, which required the use of newly developed methods. While comparisons within disorders are valid, comparisons across disorders should be made with caution. A series of articles is planned to present the results.

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2005Methods for the Economic Evaluation of Health Care Programmes 1996Cost-Effectiveness in Health and Medicine 1991Meta-Analytic Procedures for Social Research 1994Meta-Analytic Procedures for Social Research.2001Statistical Methods for Examining Heterogeneity and Combining Results from Several Studies in Meta‐Analysis 2001Systematic Reviews in Health Care 2007The burden of disease and injury in Australia 2003 2007A Guide to Treatments that Work

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