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Cost-effectiveness analysis of psychotropic therapy in adolescent patients with intellectual disability in Mental Hospital of West Java Provincial State 2015-2017


Ice L. Nur , Neily Zakiyah , Lina Budiyanti , Auliya A. Suwantika

Abstract

This research was aimed to analyse the cost-effectiveness analysis (CEA) of psychotropic therapy for adolescents with intellectual disability in Mental Hospital of West Java Provincial State from 2015 – 2017, and additionally, identify the most significant parameters affecting the cost-effectiveness each year. The participants were adolescent patients, aged between 12-18 years-old, with intellectual disability. Healthcare provider perspective was used, considering direct medical cost i.e cost of medical records, drugs, hospitalization, therapy and medical treatments, nurses, and lab fees. The effectiveness was estimated based on the incremental rate of one unit of Global Assessment of Functioning (GAF) value. In this CEA, the average cost-effectiveness ratio (ACER), incremental cost-effectiveness ratio (ICER) and univariate sensitivity analysis were assessed. The results showed that psychotropic therapy in 2015 was the most cost-effective alternative with the lowest ACER, Rp248.596 for increase of each unit GAF value compared to 2016 (Rp1.013.728) and 2017 (Rp1.316.044). ICER estimation was only assessed in 2015 and 2016, due to lower cost and effectiveness compared to 2015, it was estimated Rp14.671 for one unit of GAF. Psychotropic therapy in 2017 was a dominated alternative since it had the highest cost with the lowest effectiveness. Univariate sensitivity analysis showed that hospitalization cost was the most significant parameter that affected cost-effectiveness in each year. The hospitalization cost was daily room rate multiplied with length of stay.



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