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A cost-effectiveness analysis of school-based suicide prevention programmes
Ahern, Susan; Burke, Lee-Ann; McElroy, Brendan; Corcoran, Paul; McMahon, Elaine M.; Keeley, Helen; Carli, Vladimir; Wasserman, Camilla; Hoven, Christina W.; Sarchiapone, Marco; Apter, Alan; Balazs, Judit; Banzer, Raphaela; Bobes, Julio; Brunner, Romuald; Cosman, Doina; Haring, Christian; Kaess, Michael; Kahn, Jean-Pierre; Kereszteny, Agnes
Suicide is one of the leading causes of death among young people globally. In light of emerging evidence supporting the effectiveness of school-based suicide prevention programmes, an analysis of cost-effectiveness is required. We aimed to conduct a full cost-effectiveness analysis (CEA) of the large pan-European school-based RCT, Saving and Empowering Young Lives in Europe (SEYLE). The health outcomes of interest were suicide attempt and severe suicidal ideation with suicide plans. Adopting a payer’s perspective, three suicide prevention interventions were modelled with a Control over a 12-month time period. Incremental cost-effectiveness ratios (ICERs) indicate that the Youth Aware of Mental Health (YAM) programme has the lowest incremental cost per 1% point reduction in incident for both outcomes and per quality adjusted life year (QALY) gained versus the Control. The ICERs reported for YAM were €34.83 and €45.42 per 1% point reduction in incident suicide attempt and incident severe suicidal ideation, respectively, and a cost per QALY gained of €47,017 for suicide attempt and €48,216 for severe suicidal ideation. Cost-effectiveness acceptability curves were used to examine uncertainty in the QALY analysis, where cost-effectiveness probabilities were calculated using net monetary benefit analysis incorporating a two-stage bootstrapping technique. For suicide attempt, the probability that YAM was cost-effective at a willingness to pay of €47,000 was 39%. For severe suicidal ideation, the probability that YAM was cost-effective at a willingness to pay of €48,000 was 43%. This CEA supports YAM as the most cost-effective of the SEYLE interventions in preventing both a suicide attempt and severe suicidal ideation. Trial registration number DRKS00000214.
Keyword(s): Suicide attempt; Suicidal ideation; Prevention; Intervention; Adolescents; School; Cost-effectiveness
Publication Date:
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University College Cork
Citation(s): Ahern, S., Burke, L.-A., McElroy, B., Corcoran, P., McMahon, E. M., Keeley, H., Carli, V., Wasserman, C., Hoven, C. W., Sarchiapone, M., Apter, A., Balazs, J., Banzer, R., Bobes, J., Brunner, R., Cosman, D., Haring, C., Kaess, M., Kahn, J.-P., Kereszteny, A., Postuvan, V., Sáiz, P. A., Varnik, P. and Wasserman, D. (2018) 'A cost-effectiveness analysis of school-based suicide prevention programmes', European Child & Adolescent Psychiatry, In Press, doi:10.1007/s00787-018-1120-5
Publisher(s): Springer Verlag
File Format(s): application/pdf
First Indexed: 2018-03-14 06:30:14 Last Updated: 2019-06-15 06:38:46