Reducing the Burden of Mental Illness in Spain

Population-Level Impact and Cost-Effectiveness of Treatments in Depression and Schizophrenia

José Luis Ayuso-Mateos, Pedro Gutiérrez Recacha, Josep Maria Haro, Luis Salvador Carulla, Francisco José Vázquez Polo, Miguel Ángel Negrín Hernández, Daniel Chisholm

Social Sciences > Economics > Public EconomicsLife Sciences and Biomedicine > Health and Lifestyle

The present study aims to estimate the cost-effectiveness of interventions for reducing the burden of depression and schizophrenia in Spain and evaluate their population level impact. The study examines the cost-effectiveness of different types of clinical interventions at the level of the Spanish population.

For depression, the interventions considered are the following: 1) tricyclic antidepressants (imipramine); 2) SSRIs (fluoxetine); 3) psychotherapy; 4) tricyclic antidepressants plus psychotherapy; 5) SSRIs plus psychotherapy; 6) proactive collaboration management with tricyclic antidepressants; and 7) proactive collaboration management with SSRIs. In our analysis, interventions based on tricyclic antidepressants turned out to be the most cost-efficient option.

For schizophrenia, the interventions considered are the following: 1) current situation; 2) older antipsychotics alone; 3) new antipsychotics alone (risperidone); 4) older antipsychotics plus psychosocial treatment; 5) new antipsychotics plus psychosocial treatment; 6) older antipsychotics plus case management and psychosocial treatment; and 7) new antipsychotics plus case management and psychosocial treatment. Interventions based on the combination of old antipsychotics with psychosocial treatment or psychosocial treatment plus case management proved to be the most efficient strategies according to our analysis.


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