Browse by author
Lookup NU author(s): Dr Mark Pennington, Professor Matthew PrinaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author(s), 2024. Aims. The effectiveness and cost-effectiveness of early intervention for psychosis (EIP) services are well established in high-income countries but not in low- and middle-income countries (LMICs). Despite the scarcity of local evidence, several EIP services have been implemented in LMICs. Local evaluations are warranted before adopting speciality models of care in LMICs. We aimed to estimate the cost-effectiveness of implementing EIP services in Brazil. Methods. A model-based economic evaluation of EIP services was conducted from the Brazilian healthcare system perspective. A Markov model was developed using a cohort study conducted in São Paulo. Cost data were retrieved from local sources. The outcome of interest was the incremental cost-effectiveness ratio (ICER) measured as the incremental costs over the incremental quality-adjusted life-years (QALYs). Sensitivity analyses were performed to test the robustness of the results. Results. The study included 357 participants (38% female), with a mean (SD) age of 26 (7.38) years. According to the model, implementing EIP services in Brazil would result in a mean incremental cost of 4,478 Brazilian reals (R$) and a mean incremental benefit of 0.29 QALYs. The resulting ICER of R$ 15,495 (US dollar [USD] 7,640 adjusted for purchase power parity [PPP]) per QALY can be considered cost-effective at a willingness-to-pay threshold of 1 Gross domestic product (GDP) per capita (R$ 18,254; USD 9,000 PPP adjusted). The model results were robust to sensitivity analyses. Conclusions. This study supports the economic advantages of implementing EIP services in Brazil. Although cultural adaptations are required, these data suggest EIP services might be cost-effective even in less-resourced countries.
Author(s): Aceituno D, Razzouk D, Jin H, Pennington M, Gadelha A, Bressan R, Noto C, Crossley N, Prina M
Publication type: Article
Publication status: Published
Journal: Epidemiology and Psychiatric Sciences
Year: 2024
Volume: 33
Online publication date: 05/04/2024
Acceptance date: 02/04/2018
Date deposited: 07/05/2026
ISSN (print): 2045-7960
ISSN (electronic): 2045-7979
Publisher: Cambridge University Press
URL: https://doi.org/10.1017/S2045796024000222
DOI: 10.1017/S2045796024000222
Data Access Statement: The authors declare that all data supporting the findings of this study are available within the article and its supplementary information file.
PubMed id: 38576239
Altmetrics provided by Altmetric
