Insomnia treatment in New Zealand.
OBJECTIVE
To describe insomnia treatment in New Zealand and estimate the annual societal costs of insomnia among New Zealanders aged 20-59 years.


METHODS
Twenty-one interviews were conducted with insomnia treatment providers in New Zealand using a snowballing recruitment method. Information from the interviews and the international literature was used to estimate treatment profiles, availability, uptake and costs, as the basis for a decision analytic model with micro costing of each potential outcome. Sensitivity analyses were conducted with 10,000 Monte Carlo simulations randomly varying between each model parameter between minimum and maximum estimates.


RESULTS
The treatment provider interviews highlighted the unstructured nature of insomnia treatment in New Zealand. The net cost of treating a person with insomnia was estimated to be -$482. The net annual benefit (saving) for treating insomniacs aged between 20-59 yrs was estimated at $21.8 million.


CONCLUSIONS
The estimated total societal costs per QALY gained by treating insomnia is substantially lower than the average QALY cost-effectiveness threshold ($6,865) of PHARMAC funding decisions for new pharmaceuticals. Thus, these analyses strongly support the cost-effectiveness of insomnia treatment.
Sleep/Wake Research Centre, School of Public Health, Massey University Wellington, Wellington, New Zealand. k.m.okeeffe@massey.ac.nz
Karyn M
KM
O'Keeffe
Philippa H
PH
Gander
W Guy
WG
Scott
Helen M
HM
Scott
D000328:Adult; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D018803:Models, Economic; D009010:Monte Carlo Method; D009520:New Zealand / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy*