Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries: a systematic review

被引：6

作者：

Mutyambizi-Mafunda, Vimbayi ^{[1
]}

Myers, Bronwyn ^{[2
,3
,4
]}

Sorsdahl, Katherine ^{[5
]}

Chanakira, Esther ^{[6
]}

Lund, Crick ^{[5
,7
]}

Cleary, Susan ^{[1
]}

机构：

[1] Univ Cape Town, Sch Publ Hlth & Family Med, Fac Hlth Sci, Hlth Econ Unit, Anzio Rd Observ, ZA-7925 Cape Town, South Africa

[2] Curtin Univ, Curtin enAble Inst, Fac Hlth Sci, Kent St, Perth, WA 6102, Australia

[3] South African Med Res Council, Alcohol Tobacco & Other Drug Res Unit, Francie Zyl Dr Tygerberg, ZA-7505 Cape Town, South Africa

[4] Univ Cape Town, Groote Schuur Hosp, Neurosci Inst, Div Addict Psychiat,Dept Psychiat & Mental Hlt, 1st Floor, ZA-7925 Cape Town, South Africa

[5] Univ Cape Town, Dept Psychiat & Mental Hlth, Alan J Flisher Ctr Publ Mental Hlth, 46 Sawkins Rd, ZA-7700 Cape Town, South Africa

[6] Univ Sheffield, Sch Hlth & Related Res, Regent Court 30 Regent St, Sheffield S1 4DA, S Yorkshire, England

[7] Kings Coll London, Kings Global Hlth Inst, Inst Psychiat Psychol & Neurosci, Ctr Global Mental Hlth,Hlth Serv & Populat Res De, Crespigny Pk, London SE5 8AF, England

来源：

HEALTH POLICY AND PLANNING | 2023年 / 38卷 / 02期

基金：

英国医学研究理事会; 英国经济与社会研究理事会; 英国惠康基金;

关键词：

Common mental disorders; psychological treatment; economic evaluation; low- and middle-income countries; COST-EFFECTIVENESS THRESHOLDS; WILLINGNESS-TO-PAY; COGNITIVE-BEHAVIORAL THERAPY; RANDOMIZED CONTROLLED-TRIAL; THINKING HEALTHY PROGRAM; PRIMARY-CARE TREATMENT; PERINATAL DEPRESSION; INTERVENTIONS; UTILITY; INDIA;

D O I：

10.1093/heapol/czac069

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings and appraises the quality of economic evaluations of psychological treatments for CMDs in LMICs. We searched a range of bibliographic databases (including PubMed, EconLit, APA-PsycINFO and Cochrane library) and the African Journals Online (AJoL) and Google Scholar platforms. We used a pre-populated template to extract data and the Drummond & Jefferson checklist for quality appraisal. We present results as a narrative synthesis. The review included 26 studies, mostly from Asia (12) and Africa (9). The majority were cost-effectiveness analyses (12), some were cost-utility analyses (5), with one cost-benefit analysis or combinations of economic evaluations (8). Most interventions were considered either cost-effective or potentially cost-effective (22), with 3 interventions being not cost-effective. Limitations were noted regarding appropriateness of conclusions drawn on cost-effectiveness, the use of cost-effectiveness thresholds and application of 'societal' incremental cost-effectiveness ratios to reflect value for money (VfM) of treatments. Non-specialist health workers (NSHWs) delivered most of the treatments (16) for low-cost delivery at scale, and costs should reflect the true opportunity cost of NSHWs' time to support the development of a sustainable cadre of health care providers. There is a 4-fold increase in economic evaluations of CMD psychological treatments in the last decade over the previous one. Yet, findings from this review highlight the need for better application of economic evaluation methodology to support resource allocation towards the World Health Organization recommended first-line treatments of CMDs. We suggest impact inventories to capture societal economic gains and propose a VfM assessment framework to guide researchers in evaluating cost-effectiveness.

引用

页码：239 / 260

页数：22

共 96 条

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