Cost-effectiveness of an early intervention service for people with psychosis.
BACKGROUND
There is concern that delaying treatment for psychosis may have a negative impact on its long-term course. A number of countries have developed early intervention teams but there is limited evidence regarding their cost-effectiveness.


OBJECTIVE
To compare the costs and cost-effectiveness of an early intervention service in London with standard care.


METHODS
Individuals in their first episode of psychosis (or those who had previously discontinued treatment) were recruited to the study. Clinical variables and costs were measured at baseline and then at 6- and 18-month follow-up. Information on quality of life and vocational outcomes were combined with costs to assess cost-effectiveness.


RESULTS
A total of 144 people were randomised. Total mean costs were 11,685 pounds sterling in the early intervention group and 14,062 pounds sterling in the standard care group, with the difference not being significant (95% CI -8128 pounds sterling to 3326 pounds sterling). When costs were combined with improved vocational and quality of life outcomes it was shown that early intervention would have a very high likelihood of being cost-effective.


CONCLUSIONS
Early intervention did not increase costs and was highly likely to be cost-effective when compared with standard care.
McCrone
Paul
P
Centre for the Economics of Mental Health, PO 24, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London SE5 8AF, UK. p.mccrone@iop.kcl.ac.uk
Craig
Tom K J
TK
Power
Paddy
P
Garety
Philippa A
PA
D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008131:London; D008297:Male; D010348:Patient Care Team / Q000191:economics; D011618:Psychotic Disorders / Q000191:economics / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult