Cost-effectiveness and budget impact of a lifestyle intervention to improve cardiometabolic health in patients with severe mental illness

  • Anne Looijmans Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen and Rob Giel Research Centre, University Medical Center Groningen, University of Groningen, Groningen - The Netherlands http://orcid.org/0000-0002-3333-562X
  • Frederike Jörg Rob Giel Research Centre, University Medical Center Groningen, University of Groningen, Groningen -and Research Department, Friesland Mental Health Services, Leeuwarden - The Netherlands
  • Richard Bruggeman Rob Giel Research Centre, University Medical Center Groningen, University of Groningen, Groningen and Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen - The Netherlands
  • Robert A. Schoevers Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen - The Netherlands
  • Eva Corpeleijn Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen - The Netherlands
  • Talitha L Feenstra Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen and National Institute for Public Health and the Environment (RIVM), Bilthoven - The Netherlands
  • Antoinette D.I. van Asselt Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen and Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen - The Netherlands
Keywords: Budget impact analysis, Cardiometabolic risk, Cost-effectiveness, Lifestyle intervention, Mental health care, Severe mental illnesses

Abstract

Methods: Patients (n = 244) were randomized to receive either care-as-usual or a lifestyle intervention in which mental health nurses coached patients in changing their lifestyle by using a web tool. Costs and quality of life were assessed at baseline and at 6 and 12 months. Incremental costs per centimeter waist circumference (WC) lost and per Quality-Adjusted Life Year (QALY) gained were assessed. Budget impact was estimated based on three intervention-uptake scenarios using a societal and a third-party payer perspective.

Results: Costs and reduction in WC were higher in the intervention (n = 114) than in the control (n = 94) group after 12 months, although not statistically significant, resulting in €1,370 per cm WC lost. QALYs did not differ between the groups, resulting in a low probability of the intervention being cost-effective in cost/QALY gained. The budget impact analysis showed that for a reasonable participation of 43%, total costs were around €81 million over 5 years, or on average €16 million annually (societal perspective).

Conclusions: The intervention is not cost-effective at 12 months and the budget impact over 5 years is substantial. Possibly, 12 months was too short to implement the intervention, improve cardiometabolic health, and reduce care costs. Therefore, the incentive for this intervention cannot be found in short-term financial advantages. However, there may be benefits associated with lifestyle interventions in the long term that remain unclear.

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Published
2020-12-14
How to Cite
1.
Looijmans A, Jörg F, Bruggeman R, Schoevers R, Corpeleijn E, Feenstra T, van Asselt A. Cost-effectiveness and budget impact of a lifestyle intervention to improve cardiometabolic health in patients with severe mental illness. GRHTA [Internet]. 14Dec.2020 [cited 22Jan.2021];7(1):131-8. Available from: https://journals.aboutscience.eu/index.php/grhta/article/view/2027
Section
Mental Health Economics: the Netherlands experience