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Research

The Economics of Mental Health Care

Over the last decades, there has been discussion concerning the diagnosis, treatment, prevalence, quality of care, and cost of psychiatric disorders, notably including (although not limited to)  attention-deficit/hyperactivity disorder (ADHD) in children and adolescents [1,2]. Contrary to popular belief, results from the Nordbaden Study suggest that the prevalence of mental health disorders has not increased dramatically [3].

Original scientific contributions from the Institute for Innovation & Valuation in Health Care have included health care utilization research (Nordbaden Project) [4] and research into the cost and cost effectiveness of interventions for ADHD in children, adolescents, and adults, including the impact of co-existing conditions. In particular, health economic analyses on the basis of the NIMH initiated MTA Study strongly suggested cost effectiveness of an intense medication management strategy [5,6]. Further economic analyses based on the COMPAS project in adults with ADHD are underway [7].

References:

  1. Beecham, J.: Annual Research Review: Child and adolescent mental health interventions: a review of progress in economic studies across different disorders.  J. Child Adolesc. Psychiatry 2014; 55 (6): 714-732
  2. Schlander, M.: The pharmaceutical economics of child psychiatric drug treatment. Pharm. Design 2010; 16 (22): 2443-2461
  3. Schlander, M., Trott, G.E., Banaschewski, T., Schwarz, O.: forthcoming. – See also Presentations at the website of the Institute for Innovation & Valuation in Health Care (InnoValHC)
  4. Schlander, M., Schwarz, O., Trott, G.E., Viapiano, M., Bonauer, N.: Who cares for patients with attention-deficit/hyperactivity disorder (ADHD)? Insights from Nordbaden (Germany) on administrative prevalence and physician involvement in health care provision. Child Adolesc. Psychiatry 2007; 16: 430–438
  5. Foster, E.M., Jensen, P.S., Schlander, M., Pelham, W.E., Hechtman, L., Arnold, L.E., Swanson, J.M., Wigal, T.: Treatment for ADHD: Is more complex treatment cost-effective for more complex cases? Health Services Research, 42 (1), 2007: 165-182
  6. Jensen, P.S., Garcia, J.A., Glied, S., Crowe, M., Foster, E.M., Schlander, M., and the MTA Cooperative Group: Cost-Effectiveness of ADHD Treatments: Findings from the MTA Study. American Journal of Psychiatry 162 (9), 2005, 1628-1636
  7. Philipsen, A., Jans, T., Graf, E., Matthies, S., Borel, P.,  Colla, M., Gentschow, L., Langner, D., Jacob, C., Groß-Lesch, S., Sobanski, E., Alm, B., Schumacher-Stien, M., Roesler, M., Retz, W., Retz-Junginger, P., Kis, B., Abdel-Hamid, M., Heinrich, V., Huss, M., Kornmann, C. Bürger, A., Perlov, E., Ihorst, G., Schlander, M., Berger, M., Tebartz van Elst, L.: Comparison of Methylphenidate and Psychotherapy in Adult ADHD Study (COMPAS) Consortium: Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial. JAMA Psychiatry, 72 (12), 2015: 1199-1210