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Shared sorrow, shared costs: cost-effectiveness analysis of the empowerment group therapy approach to treat affective disorders in refugee populations

BackgroundRefugees and asylum seekers (RAS) in Germany need tailored and resource-oriented mental healthcare interventions.AimsTo evaluate the cost-effectiveness of group psychotherapy for RAS with moderate depressive symptoms.MethodThis is a post hoc cost-effectiveness analysis of Empowerment group...

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Main Authors: Strupf, Michael (Author) , Hoell, Andreas (Author) , Bajbouj, Malek (Author) , Böge, Kerem (Author) , Wiechers, Maren (Author) , Karnouk, Carine (Author) , Kamp-Becker, Inge (Author) , Banaschewski, Tobias (Author) , Meyer-Lindenberg, Andreas (Author) , Rapp, Michael (Author) , Hasan, Alkomiet (Author) , Falkai, Peter (Author) , Habel, Ute (Author) , Heinz, Andreas (Author) , Plener, Paul (Author) , Kaiser, Franziska (Author) , Weigold, Stefanie (Author) , Mehran, Nassim (Author) , Übleis, Aline (Author) , Padberg, Frank (Author)
Format: Article (Journal)
Language:English
Published: 2023
In: BJPsych Open
Year: 2023, Volume: 9, Issue: 4, Pages: 1-9
ISSN:2056-4724
DOI:10.1192/bjo.2023.504
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1192/bjo.2023.504
Verlag, kostenfrei, Volltext: https://www.cambridge.org/core/journals/bjpsych-open/article/shared-sorrow-shared-costs-costeffectiveness-analysis-of-the-empowerment-group-therapy-approach-to-treat-affective-disorders-in-refugee-populations/82B3E7E405863F247E606A3A0650992C
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Author Notes:Michael Strupf, Andreas Hoell, Malek Bajbouj, Kerem Böge, Maren Wiechers, Carine Karnouk, Inge Kamp-Becker, Tobias Banaschewski, Andreas Meyer-Lindenberg, Michael Rapp, Alkomiet Hasan, Peter Falkai, Ute Habel, Andreas Heinz, Paul Plener, Franziska Kaiser, Stefanie Weigold, Nassim Mehran, Aline Übleis and Frank Padberg
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Summary:BackgroundRefugees and asylum seekers (RAS) in Germany need tailored and resource-oriented mental healthcare interventions.AimsTo evaluate the cost-effectiveness of group psychotherapy for RAS with moderate depressive symptoms.MethodThis is a post hoc cost-effectiveness analysis of Empowerment group psychotherapy that was embedded in a stratified stepped and collaborative care model (SCCM) from the multicentre randomised controlled MEHIRA trial. One hundred and forty-nine participants were randomly assigned to SCCM or treatment as usual (TAU) and underwent Empowerment (i.e. level 3 of the SCCM for adults) or TAU. Effects were measured with the nine-item Patient Health Questionnaire (PHQ-9) and quality adjusted life-years (QALY) post-intervention. Health service and intervention costs were measured. Incremental cost-effectiveness ratios (ICER) were estimated and net monetary benefit (NMB) regressions with 95% confidence intervals were performed. Cost-effectiveness was ascertained for different values of willingness to pay (WTP) using cost-effectiveness acceptability curves for probable scenarios. Trial registration number: NCT03109028 on ClinicalTrials.gov.ResultsHealth service use costs were significantly lower for Empowerment than TAU after 1 year. Intervention costs were on average €409.6. Empowerment led to a significant change in PHQ-9 scores but not QALY. Bootstrapped mean ICER indicated cost-effectiveness according to PHQ-9 and varied considerably for QALY in the base case. NMB for a unit reduction in PHQ-9 score at WTP of €0 was €354.3 (€978.5 to −€269.9). Results were confirmed for different scenarios and varying WTP thresholds.ConclusionsThe Empowerment intervention was cost-effective in refugees with moderate depressive symptoms regarding the clinical outcome and led to a reduction in direct healthcare consumption. Concerning QALYs, there was a lack of confidence that Empowerment differed from TAU.
Item Description:Online veröffentlicht: 22. Juni 2023
Gesehen am 15.08.2023
Physical Description:Online Resource
ISSN:2056-4724
DOI:10.1192/bjo.2023.504

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