title: Cost-effectiveness of an improving access to psychological therapies service.
abstract: BACKGROUND
  Effective psychological therapies have been recommended for common mental health problems, such as depression and anxiety, but provision has been poor. Improving Access to Psychological Therapies (IAPT) may provide a cost-effective solution to this problem.
  
  
  OBJECTIVE
  To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007-2009).
  
  
  METHODS
  An economic evaluation comparing costs and health outcomes for patients at the IAPT demonstration site with those for comparator sites, including a separate assessment of lost productivity. Sensitivity analyses were undertaken.
  
  
  RESULTS
  The IAPT site had higher service costs and was associated with small additional gains in quality-adjusted life-years (QALYs) compared with its comparator sites, resulting in a cost per QALY gained of £29 500 using the Short Form (SF-6D). Sensitivity analysis using predicted EQ-5D scores lowered this to £16 857. Costs per reliable and clinically significant (RCS) improvement were £9440 per participant.
  
  
  CONCLUSIONS
  Improving Access to Psychological Therapies provided a service that was probably cost-effective within the usual National Institute for Health and Clinical Excellence (NICE) threshold range of £20 000-30 000, but there was considerable uncertainty surrounding the costs and outcome differences.
authors: Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK. c.mukuria@sheffield.ac.uk
authors: Clara
authors: C
authors: Mukuria
authors: John
authors: J
authors: Brazier
authors: Michael
authors: M
authors: Barkham
authors: Janice
authors: J
authors: Connell
authors: Gillian
authors: G
authors: Hardy
authors: Rebecca
authors: R
authors: Hutten
authors: Dave
authors: D
authors: Saxon
authors: Kim
authors: K
authors: Dent-Brown
authors: Glenys
authors: G
authors: Parry
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000191:economics; D003131:Combined Modality Therapy / Q000191:economics / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D003863:Depression / Q000628:therapy*; D005194:Family Practice; D005260:Female; D017408:Guidelines as Topic; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data*; D010352:Patient Dropouts; D015397:Program Evaluation; D011613:Psychotherapy / Q000191:economics / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000191:economics; D019057:Quality-Adjusted Life Years; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom; D055815:Young Adult