Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo

• Published in: Journal of rehabilitation medicine Vol. 50; no. 5; pp. 444 - 450
• Main Authors: Chang, Wei-Lun, Andersen, Carit Jacques, Berisha, Besa Shatri, Estrup, Olena, Wang, Shr-Jie
• Format: Journal Article
• Language: English
• Published: Sweden Journal of Rehabilitation Medicine 08.05.2018; Medical Journals Sweden
• Subjects: Clinical trials; comorbiddisorders; Comorbidity; Cost analysis; Cost benefit analysis; cost-benefit; cost-effectiveness; cost-utility; Functional impairment; Health status; Interdisciplinary aspects; Intervention; Mental health; multidisciplinaryintervention; Productivity; randomizedcontrolledtrial; Rehabilitation; Socioeconomic factors; Torture; Traumatic incidents; Utility functions; Victims; War
• ISSN: 1650-1977; 1651-2081
• DOI: 10.2340/16501977-2322

Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective. Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial. Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013. Participants were randomly assigned to an "intervention" and a "waiting-list" group. Changes in mental, emotional and physical health and functional impairment were assessed before and after treatment, along with increase in labour income as a proxy for productivity gain. The cost of an extra unit of effectiveness and an additional quality-adjusted life year were calculated. The total cost per participant was €1,322 including, or €1,019 excluding, research costs. Wide variations in costs of changes in mental, emotional and physical effectiveness were demonstrated. Multidisciplinary intervention resulted in functional improvement at a cost of €10,508 per quality-adjusted life year gained. With a mean monthly income increase to €133 (18%) after intervention, the intervention cost per participant would be equal to the total increase in monthly income after 4-5 years, assuming the increased level is maintained. Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.