Cost-effectiveness of an improving access to psychological therapies service.

British Journal of Psychiatry

PubMedID: 23307921

Mukuria C, Brazier J, Barkham M, Connell J, Hardy G, Hutten R, Saxon D, Dent-Brown K, Parry G. Cost-effectiveness of an improving access to psychological therapies service. Br J Psychiatry. 2013;202(3):220-7.
BACKGROUND
Effective psychological therapies have been recommended for common mental health problems, such as depression and anxiety, but provision has been poor. Improving Access to Psychological Therapies (IAPT) may provide a cost-effective solution to this problem.

AIMS
To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007-2009).

METHOD
An economic evaluation comparing costs and health outcomes for patients at the IAPT demonstration site with those for comparator sites, including a separate assessment of lost productivity. Sensitivity analyses were undertaken.

RESULTS
The IAPT site had higher service costs and was associated with small additional gains in quality-adjusted life-years (QALYs) compared with its comparator sites, resulting in a cost per QALY gained of £29 500 using the Short Form (SF-6D). Sensitivity analysis using predicted EQ-5D scores lowered this to £16 857. Costs per reliable and clinically significant (RCS) improvement were £9440 per participant.

CONCLUSIONS
Improving Access to Psychological Therapies provided a service that was probably cost-effective within the usual National Institute for Health and Clinical Excellence (NICE) threshold range of £20 000-30 000, but there was considerable uncertainty surrounding the costs and outcome differences.