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. 2016 May;31(4):504-13.
doi: 10.1093/heapol/czv093. Epub 2015 Oct 21.

Scaling-up essential neuropsychiatric services in Ethiopia: a cost-effectiveness analysis

Kirsten Bjerkreim Strand  1 , Dan Chisholm  2 , Abebaw Fekadu  3 , Kjell Arne Johansson  4
Affiliations

Scaling-up essential neuropsychiatric services in Ethiopia: a cost-effectiveness analysis

Kirsten Bjerkreim Strand et al. Health Policy Plan. 2016 May.

Abstract

Introduction: There is an immense need for scaling-up neuropsychiatric care in low-income countries. Contextualized cost-effectiveness analyses (CEAs) provide relevant information for local policies. The aim of this study is to perform a contextualized CEA of neuropsychiatric interventions in Ethiopia and to illustrate expected population health and budget impacts across neuropsychiatric disorders.

Methods: A mathematical population model (PopMod) was used to estimate intervention costs and effectiveness. Existing variables from a previous WHO-CHOICE regional CEA model were substantially revised. Treatments for depression, schizophrenia, bipolar disorder and epilepsy were analysed. The best available local data on epidemiology, intervention efficacy, current and target coverage, resource prices and salaries were used. Data were obtained from expert opinion, local hospital information systems, the Ministry of Health and literature reviews.

Results: Treatment of epilepsy with a first generation antiepileptic drug is the most cost-effective treatment (US$ 321 per DALY adverted). Treatments for depression have mid-range values compared with other interventions (US$ 457-1026 per DALY adverted). Treatments for schizophrenia and bipolar disorders are least cost-effective (US$ 1168-3739 per DALY adverted).

Conclusion: This analysis gives the Ethiopian government a comprehensive overview of the expected costs, effectiveness and cost-effectiveness of introducing basic neuropsychiatric interventions.

Keywords: Cost-effectiveness; ethics; mental health; neuropsychiatric disorders.

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Figures

Figure 1.
Figure 1.
Model explanation.
Figure 2.
Figure 2.
Expansion path of interventions.
Figure 3.
Figure 3.
Sensitivity analysis.
See this image and copyright information in PMC

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