Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders.
BACKGROUND
Mental health survey data are now being used proactively to decide how the burden of disease might best be reduced.


OBJECTIVE
To study the cost-effectiveness of current and optimal treatments for mental disorders and the proportion of burden avertable by each.


METHODS
Data for three affective, four anxiety and two alcohol use disorders and for schizophrenia were compared interms of cost, burden averted and efficiency of current and optimal treatment. We then calculated the burden unavertable given current knowledge. The unit of health gain was a reduction in the years lived with disability (YLDs).


RESULTS
Summing across all disorders, current treatment averted 13% of the burden, at an average cost of 30,000 Australian dollars per YLD gained. Optimal treatment at current coverage could avert 20% of the burden, at an average cost of 18,000 Australian dollars per YLD gained. Optimal treatment at optimal coverage could avert 28% of the burden, at 16,000 Australian dollars per YLD gained. Sixty per cent of the burden of mental disorders was deemed to be unavertable.


CONCLUSIONS
The efficiency of treatment varied more than tenfold across disorders. Although coverage of some of the more efficient treatments should be extended, other factors justify continued use of less-efficient treatments for some disorders.
Andrews
Gavin
G
World Health Organization Collaborating Centre for Mental Health Policy, and Policy and Epidemiology Group, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia. gavina@unsw.edu.au
Issakidis
Cathy
C
Sanderson
Kristy
K
Corry
Justine
J
Lapsley
Helen
H
D001008:Anxiety Disorders / Q000191:economics / Q000628:therapy; D001315:Australia; D001714:Bipolar Disorder / Q000191:economics / Q000628:therapy; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000191:economics; D019317:Evidence-Based Medicine; D006291:Health Policy / Q000191:economics*; D006306:Health Surveys; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics; D019964:Mood Disorders / Q000191:economics / Q000628:therapy; D011604:Psychoses, Alcoholic / Q000191:economics / Q000628:therapy; D012559:Schizophrenia / Q000191:economics / Q000628:therapy; D013997:Time Factors