title: Cost-effective psychotherapy for personality disorders in the Netherlands: the value of further research and active implementation.
abstract: OBJECTIVE
  In a budget-constrained health care system, decisions regarding resource allocation towards research and implementation are critical and can be informed by cost-effectiveness analysis. The objective of this study was to assess the societal value of conducting further research to inform reimbursement decisions and implementation of cost-effective psychotherapy for clusters B and C personality disorders (PDs).
  
  
  METHODS
  Value of information and value of implementation analyses were conducted using previously developed cost-effectiveness models for clusters B and C PDs to evaluate the parameters that contribute to most of the decision uncertainty, and to calculate the population expected values of perfect information (pEVPI) and perfect implementation (pEVPIM).
  
  
  RESULTS
  The pEVPI was estimated to be €425 million for cluster B PDs and €315 million for cluster C PDs, indicating that gathering additional evidence is expected to be cost-effective. The categories of parameters for which reduction of uncertainty would be most valuable were transition probabilities and health state costs. The pEVPIM was estimated to be €595 million for cluster B PDs and €1,372 million for cluster C PDs, suggesting that investing in implementation of cost-effective psychotherapy is likely to be worthwhile.
  
  
  CONCLUSIONS
  The societal value of additional research on psychotherapy for clusters B and C PDs is substantial, especially when prioritizing information on transition probabilities and health state costs. Active implementation of cost-effective treatment strategies into clinical practice is likely to improve the efficiency of health care provision in The Netherlands.
authors.affiliation: Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands. dsoetema@hsph.harvard.edu
authors.forename: Djøra I
authors.initials: DI
authors.lastname: Soeteman
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
authors.forename: Roel
authors.initials: R
authors.lastname: Verheul
authors.forename: Ties
authors.initials: T
authors.lastname: Hoomans
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D035843:Biomedical Research / Q000191:economics / Q000592:standards; D003362:Cost-Benefit Analysis / Q000379:methods; D003657:Decision Making; D006801:Humans; D009426:Netherlands; D010554:Personality Disorders / Q000191:economics* / Q000628:therapy*; D011613:Psychotherapy / Q000191:economics* / Q000379:methods; D019057:Quality-Adjusted Life Years; D035501:Uncertainty