Cost-effectiveness analysis of an international peer-support intervention: the UPSIDES trial

Tamara WALDMANN1, Max LACHMANN4, Yasuhiro KOTERA2, Fileuka NGAKONGWA3, Jackline NIWEMUHWEZI5, Reinhold KILIAN1

1Clinic for Psychiatry and Psychotherapy II at Ulm University at the regional clinic Günzburg, Ulm, Germany
2University of Nottingham, Nottingham, United Kingdom
3Ifakara Health Institute, Department of Health Systems, Impact Evaluation and Policy, Dar es Salaam, Tanzania
4Ben-Gurion University of the Negev, Department of Social Work, Be'er Sheva, Israel
5Butabika National Referral Hospital, Kampala, Uganda

Objectives

In the last decade, peer-support in mental health services gained raising international attention. Information regarding the cost-effectiveness of peer-support interventions in low-, middle and non-Anglophone high-income countries are lacking. This analysis tries to close this research gap, by analysing the cost-effectiveness of an international RCT – the UPSIDES trial.

 

Methods

Data was collected at six study sites in Germany, Israel, India, Tanzania and Uganda. Mental health services were assessed with the Client Sociodemographic and Service Receipt Inventory (CSSRI). Inpatient, outpatient, wellfare and justice services, as well as information about taken medication were collected. Quality of life was measured with the EQ-5D-3L and quality of life years (QALYs) were calculated, using the corresponding utility value sets. Difference in costs and QALYs were calculated and a cost-utility-ratio (ICUR) estimated. The trial was pre-registered (ISRCTN26008944). 

 

Results

The intervention group generated about I$ 600 less costs in comparison to the control group and reached higher QALY values. It was not possible to estimate site level specific ICURs due to insufficient number of persons in each study arm.

 

Conclusions

No significant cost or QALY difference between intervention and control group have been detected. The point estimate is located in the lower right quadrant (intervention dominates treatment as usual), but did not reach statistically significance. Therefore, no clear conclusion regarding cost-effectiveness of the UPSIDES intervention is possible.



Funding: EU H2020, GA 779263.