TY - JOUR
T1 - The cost-effectiveness of delivering an e-health intervention, MoodGYM, to prevent anxiety disorders among Australian adolescents
T2 - A model-based economic evaluation
AU - Lee, Yong Yi
AU - Le, Long Khanh Dao
AU - Lal, Anita
AU - Engel, Lidia
AU - Mihalopoulos, Cathrine
N1 - Funding Information:
This work was funded by the National Mental Health Commission . The views expressed in this study are solely those of the authors and do not reflect the views of the National Mental Health Commission.
Funding Information:
The current study was part of a broader research project funded by the National Mental Health Commission of Australia. This project evaluated the return-on-investment credentials of ten preventive interventions to address mental health conditions across the life span ( National Mental Health Commission, 2020 ). A common methodological framework was adopted to facilitate comparability of cost-effectiveness findings across the ten interventions. Briefly, this framework assessed the value for money credentials of in-scope interventions by simultaneously using two alternative methodologies: (1) cost-utility analysis, where net intervention costs were compared to health outcomes measured using quality-adjusted life years (QALYs); and (2) return-on-investment analysis, where the cost savings produced by an intervention were compared to the total cost of the intervention. Both sets of cost-effectiveness models were developed using an adapted version of the Assessing Cost-Effectiveness (ACE) approach ( Carter et al., 2008 ; Mihalopoulos et al., 2011 ; Vos et al., 2007 ). The current study adopted a partial societal perspective which includes productivity impacts. The cost-effectiveness model designated 2016 as the reference year, with a discount rate of 3% per year applied to all costs and health outcomes. All costs were expressed in 2016 Australian dollars (A$) and converted to 2016 prices using relevant health price deflators ( Australian Institute of Health and Welfare, 2019 ).
Publisher Copyright:
© 2021
PY - 2021/12
Y1 - 2021/12
N2 - Background: Anxiety disorders are a common mental health diagnosis among adolescents and can adversely impact health, education and social wellbeing. This study evaluated the cost-effectiveness of delivering an online e-health intervention, MoodGYM, to prevent anxiety among adolescent students. Method: A Markov model was developed to evaluate the population cost-effectiveness of delivering MoodGYM to prevent anxiety disorders among Australian students aged 11-17 years, relative to ‘no intervention’. The study conducted: (1) a cost-utility analysis to estimate an incremental cost-effectiveness ratio (ICER) expressed as a cost per quality-adjusted life year (QALYs); and (2) a return-on-investment (ROI) analysis to estimate a ROI ratio that divides total cost savings (due to health care cost savings and productivity gains) by total intervention costs. Costs, expressed in 2016 Australian dollars, and health impacts were modelled over a 10-year time horizon starting in 2016 and discounted at 3% per year. Uncertainty and sensitivity analyses were conducted to test the robustness of input parameters/assumptions. Results: Both analyses indicated that MoodGYM represents good value-for-money. The cost-utility analysis produced a dominant ICER (95% uncertainty interval [UI]: dominant–dominant), indicating the intervention produced positive health benefits and net cost savings. The ROI analysis produced an ROI ratio of 3.06 (95% UI: 1.33–7.85), denoting a return of A$3.06 for every A$1 invested. Conclusion: Delivering MoodGYM to Australian students aged 11-17 years can produce net cost savings and should be considered for scale up across schools in Australia. Access to the intervention may be hindered by poor internet connectivity in rural/remote regions.
AB - Background: Anxiety disorders are a common mental health diagnosis among adolescents and can adversely impact health, education and social wellbeing. This study evaluated the cost-effectiveness of delivering an online e-health intervention, MoodGYM, to prevent anxiety among adolescent students. Method: A Markov model was developed to evaluate the population cost-effectiveness of delivering MoodGYM to prevent anxiety disorders among Australian students aged 11-17 years, relative to ‘no intervention’. The study conducted: (1) a cost-utility analysis to estimate an incremental cost-effectiveness ratio (ICER) expressed as a cost per quality-adjusted life year (QALYs); and (2) a return-on-investment (ROI) analysis to estimate a ROI ratio that divides total cost savings (due to health care cost savings and productivity gains) by total intervention costs. Costs, expressed in 2016 Australian dollars, and health impacts were modelled over a 10-year time horizon starting in 2016 and discounted at 3% per year. Uncertainty and sensitivity analyses were conducted to test the robustness of input parameters/assumptions. Results: Both analyses indicated that MoodGYM represents good value-for-money. The cost-utility analysis produced a dominant ICER (95% uncertainty interval [UI]: dominant–dominant), indicating the intervention produced positive health benefits and net cost savings. The ROI analysis produced an ROI ratio of 3.06 (95% UI: 1.33–7.85), denoting a return of A$3.06 for every A$1 invested. Conclusion: Delivering MoodGYM to Australian students aged 11-17 years can produce net cost savings and should be considered for scale up across schools in Australia. Access to the intervention may be hindered by poor internet connectivity in rural/remote regions.
KW - Adolescent
KW - Anxiety disorders
KW - Cost-utility analysis
KW - Economic evaluation
KW - Internet-based intervention
KW - Primary prevention
KW - Return on investment
UR - https://www.scopus.com/pages/publications/85114171006
U2 - 10.1016/j.mhp.2021.200210
DO - 10.1016/j.mhp.2021.200210
M3 - Article
AN - SCOPUS:85114171006
SN - 2212-6570
VL - 24
JO - Mental Health & Prevention
JF - Mental Health & Prevention
M1 - 200210
ER -
SDG 3 Good Health and Well-being