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Open Access Research article

Cost-effectiveness analysis of psychosocial intervention for early stage schizophrenia in China: a randomized, one-year study

Zhanchou Zhang1, Jinguo Zhai2, Qinling Wei3, Jingfeng Qi1, Xiaofeng Guo1* and Jingping Zhao1*

Author Affiliations

1 Institute of Mental Health, the Second Xiangya Hospital, Central South University, Key Laboratory of Psychiatry and Mental Health of Hunan Province, National Technology Institute of Psychiatry, No. 139 Renmin Middle Road, Changsha 410011, China

2 Jining Medical College, Jining, China

3 Department of Psychiatry, 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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BMC Psychiatry 2014, 14:212  doi:10.1186/s12888-014-0212-0

Published: 26 July 2014

Abstract

Background

A combination of psychosocial interventions and medications has been highly recommended as a successful treatment package for schizophrenia. Its cost-effectiveness has not been fully explored yet. The aim of the present analysis was to evaluate the cost-effectiveness of antipsychotics combined with psychosocial treatment and treatment as usual for patients with early-stage schizophrenia.

Method

Patients with schizophrenia (N = 1, 268) were assigned to the combination of medication and psychosocial intervention or treatment as usual for up to 12 months. Cost analysis included direct medical costs, direct nonmedical costs and indirect costs. Quality-adjusted life year (QALY) ratings were assessed with Short- Form 6D.

Results

Average monthly psychosocial intervention costs for combined treatment were higher than treatment as usual (p = 0.005), but no significant differences were found in direct costs, indirect costs, and total costs between two groups (all p-values ≥ 0.556). Combined treatment was associated with significant higher QALY ratings than treatment as usual (p = 0.039). Compared with treatment as usual, combined treatment resulted in a gain of 0.031 QALY ratings at an additional cost of US$ 56.4, yielding an incremental cost-effectiveness ratio of US$ 1819.4 per QALY gained.

Conclusions

Despite some limitations, our results supported that medication combined with psychosocial treatment was more cost-effective than treatment as usual for patients with early-stage schizophrenia.

Trial registration

clinicaltrials.gov Identifier: NCT00654576 webcite

Keywords:
Schizophrenia; Cost-effectiveness; Psychosocial intervention