Home > A cost-effectiveness analysis of school-based suicide prevention programmes.

Ahern, Susan and Burke, Lee Ann and McElroy, Brendan and Corcoran, Paul and McMahon, Elaine M and Keeley, Helen and Carli, Vladimir and Wasserman, Camilla and Hoven, Christina W and Sarchiapone, Marco and Apter, Alan and Balazs, Judit A and Banzer, Raphaela and Bobes, Julio and Brunner, Romuald and Cosman, Doina and Haring, Christian and Kaess, Michael and Kahn, Jean Pierre and Kereszteny, Agnes (2018) A cost-effectiveness analysis of school-based suicide prevention programmes. European Child & Adolescent Psychiatry, 27, (10), pp. 1295-1304. https://doi.org/10.1007/s00787-018-1120-5.

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.


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