Schizophrenia treatment in the developing world: an interregional and multinational cost-effectiveness analysis.
OBJECTIVE: Schizophrenia is a highly disabling disease and is costly to treat. We set out to establish what are the most cost-effective interventions applicable to developing regions and countries. METHODS: Analysis was undertaken at the level of three WHO subregions spanning the Americas, Africa an...
| Publicado en: | Bulletin of the World Health Organization Vol. 86; no. 7; pp. 542 - 552 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
World Health Organization
Jul2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105656850&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105656850 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00429686 BUW jtl: Bulletin of the World Health Organization issn: 00429686 maglogo: N pubinfo: dt: Jul2008 vid: 86 iid: 7 pid: 437 pub: World Health Organization artinfo: ui: 105656850 105656850 2009976741 10.2471/blt.07.045377 NLM18670667 105656850 ppf: 542 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Schizophrenia treatment in the developing world: an interregional and multinational cost-effectiveness analysis. aug: au: Chisholm D Gureje O Saldivia S Villalon Calderon M Wickremasinghe R Mendis N Ayuso-Mateos J Saxena S affil: Department of Health Systems Financing, WHO, Geneva, Switzerland sug: subj: Health Care Costs Evaluation Schizophrenia Chile Cost Benefit Analysis Descriptive Statistics Funding Source Health Policy Trends Nigeria Schizophrenia Drug Therapy Schizophrenia Economics Schizophrenia Epidemiology Schizophrenia Therapy Sri Lanka Human ab: OBJECTIVE: Schizophrenia is a highly disabling disease and is costly to treat. We set out to establish what are the most cost-effective interventions applicable to developing regions and countries. METHODS: Analysis was undertaken at the level of three WHO subregions spanning the Americas, Africa and South-East Asia, and subsequently in three member states (Chile, Nigeria and Sri Lanka). A state transition model was used to estimate the population-level health impact of older and newer antipsychotic drugs, alone or in combination with psychosocial intervention. Total population-level costs (in international dollars or local currencies) and effectiveness (measured in disability-adjusted life years averted) were combined to form cost-effectiveness ratios. FINDINGS: The most cost-effective interventions were those using older antipsychotic drugs combined with psychosocial treatment, delivered via a community-based service model (I$ 2350-7158 per disability-adjusted life year averted across the three subregions, I$ 1670-3400 following country-level contextualisation within each of these subregions). The relative cost-effectiveness of interventions making use of newer, 'atypical' antipsychotic drugs is estimated to be much less favourable. CONCLUSION: By moving to a community-based service model and selecting efficient treatment options, the cost of substantially increasing treatment coverage is not high (less than I$ 1 investment per capita). Taken together with other priority-setting criteria such as disease severity, vulnerability and human rights protection, this study suggests that a great deal more could be done for persons and families living under the spectre of this disorder. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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