Cost-effectiveness of Positive Memory Training (PoMeT) for the treatment of depression in schizophrenia

Simon, J., Kiss, N., Korrelboom, K., Kingdon, D., Wykes, T., Phiri, P., van der Gaag, M., Baksh, M. F. ORCID: https://orcid.org/0000-0003-3107-8815 and Steel, C. (2022) Cost-effectiveness of Positive Memory Training (PoMeT) for the treatment of depression in schizophrenia. International Journal of Environmental Research and Public Health, 19 (19). 11985. ISSN 1660-4601 doi: 10.3390/ijerph191911985

Abstract/Summary

Background: The Positive Memory Training (PoMeT) trial demonstrated reduced depression symptoms at 3 months for schizophrenia, but its longer-term outcome and cost impacts remain unknown. Methods: Within-trial cost-utility analysis with quality-adjusted life years (QALYs) as outcome based on health-related quality of life (HRQoL) measurement. Secondary outcome anal-yses of capability well-being. The incremental cost-effectiveness of PoMeT was compared to Treatment As Usual only (TAU) over 9 months from the ‘health and social’ care and ‘societal’ perspectives. Uncertainty was explored using bootstrapping and sensitivity analyses for cost out-liers and outcome methods. Results: HRQoL improvement was observed for both PoMeT and TAU at 3 months, but reached statistical significance and was sustained only for TAU. There was no change in capability well-being and no significant group difference in QALYs gained over 9 months. Mean intervention cost was £823. Compared to TAU, PoMeT had significantly higher mental health care costs (+£1251, 95% CI £185 to £2316) during the trial, but ‘health and social care’ and ‘societal’ cost differences were non-significant. Compared to the before-trial period, psychiatric medication costs increased significantly in both groups. The probability of PoMeT being cost-effective at 9 months was <30% and decreased further in sensitivity analyses. Conclusions: PoMeT is unlikely to be cost-effective in the given format. Generalizability remains limited since the before-after cost analysis revealed additional treatment effects also in the TAU group that likely diminished the in-cremental impacts and cost-effectiveness of PoMeT. It is not clear whether an active post-intervention follow-up could result in sustained longer-term effects and improved cost-effectiveness.

Item Type	Article
URI	https://reading-clone.eprints-hosting.org/id/eprint/107380
Identification Number/DOI	10.3390/ijerph191911985
Refereed	Yes
Divisions	Science > School of Mathematical, Physical and Computational Sciences > Department of Mathematics and Statistics
Publisher	MDPI
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