Cost-utility analysis of the UPRIGHT intervention promoting resilience in adolescents

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• dc.contributor.author Mar, Javier
• dc.contributor.author Larrañaga, Igor
• dc.contributor.author Ibarrondo, Oliver
• dc.contributor.author González-Pinto, Ana
• dc.contributor.author Hayas, Carlota las
• dc.contributor.author Fullaondo, Ane
• dc.contributor.author Izco‑Basurko, Irantzu
• dc.contributor.author Alonso Caballero, Jordi
• dc.contributor.author Zorrilla, Iñaki
• dc.contributor.author Fernández-Sevillano, Jessica
• dc.contributor.author Manuel Keenoy, Esteban de
• dc.contributor.author UPRIGHT Consortium
• dc.date.accessioned 2023-05-17T05:47:17Z
• dc.date.available 2023-05-17T05:47:17Z
• dc.date.issued 2023
• dc.description.abstract Background: As mental health in adulthood is related to mental status during adolescence, school-based interventions have been proposed to improve resilience. The objective of this study was to build a simulation model representing the natural history of mental disorders in childhood, adolescence and youth to estimate the cost-effectiveness of the UPRIGHT school-based intervention in promoting resilience and mental health in adolescence. Methods: We built a discrete event simulation model fed with real-world data (cumulative incidence disaggregated into eight clusters) from the Basque Health Service database (609,381 individuals) to calculate utilities (quality-adjusted life years [QALYs]) and costs for the general population in two scenarios (base case and intervention). The model translated changes in the wellbeing of adolescents into different risks of mental illnesses for a time horizon of 30 years. Results: The number of cases of anxiety was estimated to fall by 5,125 or 9,592 and those of depression by 1,269 and 2,165 if the effect of the intervention lasted 2 or 5 years respectively. From a healthcare system perspective, the intervention was cost-effective for all cases considered with incremental cost-utility ratios always lower than €10,000/QALY and dominant for some subgroups. The intervention was always dominant when including indirect and non-medical costs (societal perspective). Conclusions: Although the primary analysis of the trial did not did not detect significant differences, the UPRIGHT intervention promoting positive mental health was dominant in the economic evaluation from the societal perspective. Promoting resilience was more cost-effective in the most deprived group. Despite a lack of information about the spillover effect in some sectors, the economic evaluation framework developed principally for pharmacoeconomics can be applied to interventions to promote resilience in adolescents. As prevention of mental health disorders is even more necessary in the post-coronavirus disease-19 era, such evaluation is essential to assess whether investment in mental health promotion would be good value for money by avoiding costs for healthcare providers and other stakeholders.
• dc.description.sponsorship This work has been conducted within the UPRIGHT project, which is funded by the European Union’s Horizon 2020 framework programme for research and innovation under grant agreement No. 754919. This paper reflects only the views of the authors, and the European Union is not responsible for any use that may be made of the information it contains. The funding body has had no role in the study design, writing of the protocol or the decision to submit the paper for publication.
• dc.format.mimetype application/pdf
• dc.identifier.citation Mar J, Larrañaga I, Ibarrondo O, González-Pinto A, Hayas Cl, Fullaondo A, et al. Cost-utility analysis of the UPRIGHT intervention promoting resilience in adolescents. BMC Psychiatry. 2023 Mar 17;23(1):178. DOI: 10.1186/s12888-023-04665-4
• dc.identifier.doi http://dx.doi.org/10.1186/s12888-023-04665-4
• dc.identifier.issn 1471-244X
• dc.identifier.uri http://hdl.handle.net/10230/56844
• dc.language.iso eng
• dc.publisher BioMed Central
• dc.relation.ispartof BMC Psychiatry. 2023 Mar 17;23(1):178
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/754919
• dc.rights © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Adolescents health
• dc.subject.keyword Health policy
• dc.subject.keyword Mental disorders
• dc.subject.keyword Mental health
• dc.subject.keyword Prevention
• dc.subject.keyword Resilience
• dc.subject.keyword Simulation model
• dc.title Cost-utility analysis of the UPRIGHT intervention promoting resilience in adolescents
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion