Journal article
Appraisal of patient-level health economic models of severe mental illness: systematic review
- Abstract:
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Background
Healthcare decision makers require accurate long-term economic models to evaluate the cost-effectiveness of new mental health interventions.Aims
To assess the suitability of current patient-level economic models to estimate long-term economic outcomes in severe mental illness.Method
We undertook pre-specified systematic searches in MEDLINE, Embase and PsycINFO to identify reviews and stand-alone publications of economic models of interventions for schizophrenia, bipolar disorder and major depressive disorder (PROSPERO: CRD42020158243). We screened paper titles and abstracts to identify unique patient-level economic models. We conducted a structured extraction of identified models, recording the presence of key predefined model features. Model quality and validation were appraised using the 2014 ISPOR and 2016 AdViSHE model checklists.Results
We identified 15 unique patient-level models for psychosis and major depressive disorder from 1481 non-duplicate records. Models addressed schizophrenia (n = 6), bipolar disorder (n = 2) and major depressive disorder (n = 7). The predominant model type was discrete event simulation (n = 9). Model complexity and incorporation of patient heterogeneity varied considerably, and only five models extrapolated costs and outcomes over a lifetime horizon. Key model parameters were often based on low-quality evidence, and checklist quality assessment revealed weak model verification procedures.Conclusions
Existing patient-level economic models of interventions for severe mental illness have considerable limitations. New modelling efforts must be supplemented by the generation of good-quality, contemporary evidence suitable for model building. Combined effort across the research community is required to build and validate economic extrapolation models suitable for accurately assessing the long-term value of new interventions from short-term clinical trial data.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 578.6KB, Terms of use)
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- Publisher copy:
- 10.1192/bjp.2021.121
Authors
- Publisher:
- Cambridge University Press
- Journal:
- British Journal of Psychiatry More from this journal
- Volume:
- 220
- Issue:
- 2
- Pages:
- 86–97
- Publication date:
- 2021-08-19
- Acceptance date:
- 2021-07-22
- DOI:
- EISSN:
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1472-1465
- ISSN:
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0007-1250
- Language:
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English
- Keywords:
- Pubs id:
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1191795
- Local pid:
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pubs:1191795
- Deposit date:
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2021-08-23
Terms of use
- Copyright holder:
- Altunkaya et al.
- Copyright date:
- 2021
- Rights statement:
- Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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