Abstract
Background
Previous research demonstrated the effectiveness of an add-on module in reducing intrusive suicidal mental images in patients with elevated depression symptoms indicative of a depressive disorder. This study assessed the cost-effectiveness of combining this module with treatment as usual (TAU) versus TAU-alone.
Research design and methods
A randomized controlled trial of 91 participants (46 add-on+TAU, 45 TAU). Cost-effectiveness was assessed over 12 months using quality-adjusted life years (QALYs) as the primary outcome. Healthcare, patient, and work-related costs were measured. Health-related quality of life was assessed using EQ-5D-5 L at baseline, and after 3, 6, 9, and 12 months.
Results
The add-on+TAU group showed slightly higher QALYs (0.674) than TAU-group (0.630) after 12 months. From a societal perspective, the intervention yielded an incremental cost-effectiveness ratio of €137,285 per QALY gained (95% CI: -€7,338 to €15,656; QALY gain: 0.0274). Healthcare costs were higher in the add-on+TAU group, primarily due to increased outpatient mental care costs (including intervention costs of €524.02/participant). The intervention showed a 35% probability of cost-effectiveness at an €80,000 willingness-to-pay threshold.
Conclusions
Although the add-on module reduced suicidal mental images, its cost-effectiveness remains uncertain. Modest QALY improvements did not justify increased healthcare and societal costs. Larger-scale studies with extended follow-up are needed.
Previous research demonstrated the effectiveness of an add-on module in reducing intrusive suicidal mental images in patients with elevated depression symptoms indicative of a depressive disorder. This study assessed the cost-effectiveness of combining this module with treatment as usual (TAU) versus TAU-alone.
Research design and methods
A randomized controlled trial of 91 participants (46 add-on+TAU, 45 TAU). Cost-effectiveness was assessed over 12 months using quality-adjusted life years (QALYs) as the primary outcome. Healthcare, patient, and work-related costs were measured. Health-related quality of life was assessed using EQ-5D-5 L at baseline, and after 3, 6, 9, and 12 months.
Results
The add-on+TAU group showed slightly higher QALYs (0.674) than TAU-group (0.630) after 12 months. From a societal perspective, the intervention yielded an incremental cost-effectiveness ratio of €137,285 per QALY gained (95% CI: -€7,338 to €15,656; QALY gain: 0.0274). Healthcare costs were higher in the add-on+TAU group, primarily due to increased outpatient mental care costs (including intervention costs of €524.02/participant). The intervention showed a 35% probability of cost-effectiveness at an €80,000 willingness-to-pay threshold.
Conclusions
Although the add-on module reduced suicidal mental images, its cost-effectiveness remains uncertain. Modest QALY improvements did not justify increased healthcare and societal costs. Larger-scale studies with extended follow-up are needed.
| Original language | English |
|---|---|
| Pages (from-to) | 267-277 |
| Number of pages | 11 |
| Journal | Expert Review of Pharmacoeconomics & Outcomes Research |
| Volume | 26 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 17 Dec 2025 |
Keywords
- Suicide
- suicidal intrusions
- mental images
- eye movements
- dual task
- quality-adjusted life years
- cost-effectiveness
