Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-20T06:43:27.989Z Has data issue: false hasContentIssue false

Cost-effectiveness in the treatment of schizophrenia

Published online by Cambridge University Press:  16 April 2020

MRJ Knapp*
Affiliation:
Centre for the Economics of Mental Health, Institute of Psychiatry, University of London, 7 Windsor Walk, Denmark Hill, LondonSE5 8BB, UKPersonal Social Services Research Unit, London School of Economics, UK
Get access

Summary

This paper discusses the need for a health economics perspective and some of the central methodological issues raised by economic appraisals, including cost-effectiveness and cost-utility analyses. It illustrates how cost-effectiveness studies can inform policy and practice decisions concerning the treatment of schizophrenia, focusing on five generic evaluation questions commonly raised. Examples are drawn from recent and current UK research.

Type
Research Article
Copyright
Copyright © Elsevier, Paris 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This paper is lodged as Personal Social Services Research Unit Discussion Paper 1063 and Centre for the Economics of Mental Health Working Paper 025. Parts of this paper are adapted from Knapp (1994).

References

Addington, DEJones, BBloom, DChouinard, GRemington, GAlbright, PReduction of hospital days in chronic schizophrenia patients treated with risperidone: a retrospective study. Clin Therapeut 1993; 15: 917926Google ScholarPubMed
Anderson, JDayson, DWillis, Wet al.The TAPS Project. 13: Clinical and social outcomes of long-stay psychiatric patients after one year in the community Br J Psychiatry 162 1993 suppl 19 4556CrossRefGoogle Scholar
Andrews, GHall, WGoldstein, Get al.The economic costs of schizophrenia: implications for public policy Arch of Gen Psychiatry 1985 42 537543CrossRefGoogle ScholarPubMed
Backhouse, MEBackhouse, RJEdey, SAEconomic evaluation bibliography. Health Econ 1992; 1(suppl) : 1236Google Scholar
Burns, TRaftery, JBeardsmoore, AMcGuigan, SDickson, MA controlled trial of home-based acute psychiatric services. II: treatments patterns and costs. Br J Psychiatry 1993; 163: 5561CrossRefGoogle ScholarPubMed
Carr-Hill, RMorris, JCurrent practice in obtaining the ‘Q’ in QALYs: a cautionary note. Br Med J 1991; 303: 699701CrossRefGoogle ScholarPubMed
Chisholm, DHealey, AKnapp, MRJQALYs and mental health care Soc Psychiatry Psychiatr Epidemiol 1996(in press)Google Scholar
Clark, REFox, TSA framework for evaluating the economic impact of case management. Hosp Comm Psychiatry 1993; 44: 469473Google ScholarPubMed
Coid, JFailure in community care: psychiatric dilemma. Br Med J 1994; 308: 805806CrossRefGoogle ScholarPubMed
Davies, LMDrummond, MFThe economic burden of schizophrenia. Psychiatr Bull 1990; 14: 522525CrossRefGoogle Scholar
Davies, LMDrummond, MFAssessment of costs and benefits of drug therapy for treatment-resistant schizophrenia in the United Kingdom. Br J Psychiatry 1993; 162: 3842CrossRefGoogle ScholarPubMed
Department of Health Mental Illness Handbook (of The Health of the Nation) London: HMSO, 1993Google Scholar
Donnolly, MMays, NMcGilloway, Set al.Leaving long-stay hospital in Northern Ireland: care in the community for people discharged from psychiatric and mental handicap hospitals. London: Queen's Univ Belfast, 1994Google Scholar
Drummond, MFPrinciples of Economic Appraisal in Health Care Oxford University Press 1980Google Scholar
Drummond, MFStoddart, GLTorrance, GWMethods for the Economic Evaluation and Health Care Programmes. Oxford: Oxford Medical Publications, 1987Google Scholar
Eichelman, BHartwig, AEthical issues in selecting patients for treatment with clozapine: a commentary. Hosp Comm Psychiatry 1990; 41: 880882Google ScholarPubMed
Goldacre, MShiwach, RYeates, DEstimating incidence and prevalence of treated psychiatric disorders from routine statistics: the example of schizophrenia J Epidemiol Public Health 1994 (in press)Google ScholarPubMed
Gudex, CThe QALY: how can it be used?. In: Baldwin, SGodfrey, CPropper, C eds. Qualty of Life: Perspectives and Policies. Oxford: Routledge, 1990Google Scholar
Hallam, ABeecham, JKKnapp, MRJFenyo, AThe costs of accommodation and care: community provision for former long-stay psychiatric hospital patients. Eur Arch Psychiatry Clin Neurosci 1994; 243: 304310CrossRefGoogle ScholarPubMed
Healy, DPsychopharmacology and the ethics of resource allocation. Br J Psychiatry 1993; 162: 2329CrossRefGoogle ScholarPubMed
Huxley, PSocial services assessment and care management: getting it right. J Ment Health 1992; 1: 285294CrossRefGoogle Scholar
Kavanagh, SStewart, AEconomic evaluations of mental health care: modes and methods. In: Knapp, MRJ eds. The Economic Evaluation of Mental Health Care. London: Arena, 1995Google Scholar
Kingdon, DFTurkington, DCognitive Therapy in Schizophrenia. Aldershot: Guilford Press, 1993Google Scholar
Knapp, MRJThe health economics of schizophrenia treatment. Clinician 1221994 3952Google Scholar
Knapp, MRJ eds. The Economic Evaluation of Mental Health Care. New York: Arena, 1995Google Scholar
Knapp, MRJCosting mental health services: towards an understanding of cost-effectiveness. In: Creed, FTyrer, P eds. Evaluation of Community Psychiatric Services. Aldershot: Cambridge University Press, 1995Google Scholar
Knapp, MRJMaking music out of noise: the cost function approach to evaluation Br J Psychiatry 1996(suppl): (in press)Google Scholar
Knapp, MRJCambridge, PThomason, CBeecham, JKAllen, CDarton, RCare in the Community: Challenge and Demonstration. Cambridge: Ashgate, 1992Google Scholar
Knapp, MRJBeecham, JProgramme level and systems level health economics considerations. In: Thornicroft, GKnudson, HC eds. Mental Health Service Evaluations. Aldershot: Cambridge University Press, 1996Google Scholar
Knapp, MRJBeecham, JKKoutsogeorgopoulou, Vet al.A controlled study of home- versus hospital-based care for people with serious mental illness: service use and costs Br J Psychiatry 165 1994 195203CrossRefGoogle ScholarPubMed
Knapp, MRJBeecham, JFenyo, AHallam, APredicting costs from needs and diagnosis: community mental health care for former hospital in-patients Br J Psychiatry 1995(suppl)CrossRefGoogle ScholarPubMed
McCrone, PBeecham, JKKnapp, MRJCommunity psychiatric nurses in an intensive community support team: cost-effectiveness comparisons with generic CPN care. Br J Psychiatry 1994; 165: 218221CrossRefGoogle Scholar
Marks, IMConnolly, JMuijen, M.McNamee, GAudini, BLawrence, REHome-based vs in/out-patient care for serious mental illness: a controlled study. Br J Psychiatry 1994; 165: 179184CrossRefGoogle Scholar
Melzer, DHale, ASMalik, SJHogman, GAWoods, SCommunity care for patients with schizophrenia one year after hospital discharge. Br Med Journal 1991; 303: 10231026CrossRefGoogle ScholarPubMed
North, CRitchie, JFactors Influencing the Implementation of the Care Programme Approach. Cambridge: HMSO, 1993Google Scholar
Pelonaro, ALElliott, RLEthical and clinical considerations in selecting patients who will receive clozapine. Hosp Comm Psychiatry 1990; 41: 878880Google Scholar
Ritchie, JHDick, DLingham, RThe Report of the Inquiry into the Care and Treatment of Christopher Clunis. London: HMSO, 1994Google Scholar
Rosser, RFrom health indicators to Quality Adjusted Life Years: technical and ethical issues. In: Hopkins, ACostain, D eds. Measuring the Outcomes of Medical Care. London: RCP Press, 1990Google Scholar
Rupp, AKeith, SJThe costs of schizophrenia. Psychiatr Clin North Am 1993; 16: 413423CrossRefGoogle ScholarPubMed
Schneider, JCosting the care programme approach. In: Knapp, MRJ eds. The Economic Evaluation of Mental Health Care. London: Arena, 1995Google Scholar
Selai, CRosser, RThe role of quality of life measurement in psychiatry. Curr Med Lit - Psychiatry 1993; 4: 6771Google Scholar
Stein, LITest, MAAlternative to mental hospital treatment: conceptual model, treatment program and clinical evaluation. Arch Gen Psychiatry 1980; 37: 392397CrossRefGoogle ScholarPubMed
Tarrier, NBeckett, RHarwood, MSBaker, AYusopoff, LUgarteburn, IA trial of two cognitive-behavioural methods of treating drug-resistant residual psychoticsymptoms in schizophrenic patients: I, Outcome. Br J Psychiatry 1993; 162: 524532CrossRefGoogle Scholar
Weller, MPIMuijen, MDimensions of Community Mental Health Care. Aldershot: WB Saunders, 1993Google Scholar
Wilkinson, GCroft-Jeffreys, CKrekorian, HMcLees, SFalloon, IQALYs in psychiatric care?. Psychiatr Bull 1990; 14: 582585CrossRefGoogle Scholar
Wilkinson, GWilliams, BKrekorian, HMcLees, SFalloon, IQALYs in mental health: a case study. Psychologic Med 1992; 22: 725731CrossRefGoogle ScholarPubMed
Williams, AThe cost benefit approach. Br Med Bull 1974; 30: 252256CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.