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Generic preference-based measures (EuroQoL-5D (EQ-5D) and SF-6D) are used
in the economic evaluation of mental health interventions. However, there
are inconsistent findings regarding their psychometric properties.
To investigate the psychometric properties of the EQ-5D and SF-6D in
different mental health conditions, using seven existing data-sets.
The construct validity and responsiveness of the measures were assessed
in comparison with condition-specific indicators.
Evidence for construct validity and responsiveness in common mental
health and personality disorders was found (correlations 0.22–0.64;
effect sizes 0.37–1.24; standardised response means 0.45–1.31). There was
some evidence for validity in schizophrenia (correlations 0.05–0.43), but
responsiveness was unclear.
EQ-5D and SF-6D can be used in the economic evaluation of interventions
for common mental health problems with some confidence. In schizophrenia,
a preference-based measure focused on the impact of mental health should
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.
To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007–2009).
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.
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.
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.
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