title: Cost-effectiveness of treating first-episode psychosis: five-year follow-up results from an Italian early intervention programme.
abstract: OBJECTIVE
  Early intervention programmes are expected to result in the reduction of illness severity in patients with schizophrenia, and contain health-care costs by reducing hospital admissions and improving the social functioning of patients. This study aimed to investigate the cost-effectiveness of treatment in an early intervention programme in comparison to standard care.
  
  
  METHODS
  Retrospective analysis of data prospectively recorded in an urban area (Milan, Italy). Twenty-three patients from an early intervention programme and 23 patients from standard care with first-episode psychosis were evaluated on their use of services over a 5-year period. The Health of the Nation Outcome Scale was used to measure clinical status.
  
  
  RESULTS
  Significant changes with respect to initial assessment were recorded on the Health of the Nation Outcome Scale, with larger effect sizes in the early intervention programme than in the standard care group. Consequently, the cost-effectiveness ratio per reduced score of severity was lower in the early intervention programme than in standard care (€ 4802 vs. € 9871), with an incremental cost-effectiveness ratio, or net saving of €-1204 for every incremental reduced score of severity. Over time, greater recourse to hospital and residential facilities to obtain comparable improvement in symptoms resulted in a steady cost increase for the patients in standard care.
  
  
  CONCLUSIONS
  Allocation of funds to specialized early intervention programmes is the best alternative, as it can save costs by reducing the use of hospitals and residential facilities, and may produce net savings of costs in the long term.
authors: Department of Mental Health, Center for early detection and intervention in psychosis-Programma2000, Niguarda Ca' Granda Hospital, Milan, Italy. angelo.cocchi@ospedaleniguarda.it
authors: Angelo
authors: A
authors: Cocchi
authors: Vittorio
authors: V
authors: Mapelli
authors: Anna
authors: A
authors: Meneghelli
authors: Antonio
authors: A
authors: Preti
mesh_terms: D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D061345:Early Medical Intervention / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D008297:Male; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000191:economics* / Q000628:therapy