The Cost-Effectiveness of the Improving Access to Psychological Therapies (IAPT) Programme in Severe Mental Illness: A Decision Analytical Model Using Routine Data

• Published in: Community mental health journal Vol. 55; no. 5; pp. 873 - 883
• Main Authors: Zala, Darshan, Brabban, Alison, Stirzaker, Alex, Kartha, Muralikrishnan Radhakrishnan, McCrone, Paul
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-07-2019; Springer Nature B.V
• Subjects: Access; Bipolar disorder; Clinical outcomes; Community and Environmental Psychology; Cost analysis; Health care expenditures; Health services; Internal validity; Medicine; Medicine & Public Health; Mental disorders; Mental health; Original Paper; Patients; Personality disorders; Psychiatry; Psychological intervention; Psychosis; Treatment outcomes; Severe mental illness; Improving access to psychological therapies; Cost-effectiveness; IAPT; Economic evaluation
• ISSN: 0010-3853; 1573-2789
• DOI: 10.1007/s10597-019-00390-z

This is the first site level economic evaluation of the Improving Access to Psychological Therapies programme for severe mental illness (IAPT-SMI) that is funded by NHS England. It also aims to illustrate the challenges involved in evaluations based on routine data with low internal validity. Six IAPT-SMI pilot sites treated 1 of 2 clinical groups: (i) psychosis or bipolar disorder; (ii) personality disorder. A decision analytical model nested in a before-after framework- the same patients 12 months after treatment versus 12 months before treatment—was used to compare the cost-effectiveness of IAPT-SMI with treatment as usual (TAU). IAPT-SMI appears to be more costly overall but save non-psychological treatment costs. There is evidence it may improve function and lower incidence of harmful behaviour. However, there is a need for evaluations with a more conventional study design that measure a more comprehensive array of resource use and clinical outcomes.