The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders
Abstract
BACKGROUND: The present paper describes a component of a large population cost-effectiveness study that aimed to identify the averted burden and economic efficiency of current and optimal treatment for the major mental disorders. This paper reports on the findings for the anxiety disorders (panic disorder/agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder and obsessive compulsive disorder). METHOD: Outcome was calculated as averted 'years lived with disability' (YLD), a population summary measure of disability burden. Costs were the direct health care costs in 1997-8 Australian dollars. The cost per YLD averted (efficiency) was calculated for those already in contact with the health system for a mental health problem (current care) and for a hypothetical optimal care package of evidence-based treatment for this same group. Data sources included the Australian National Survey of Mental Health and Well-being and published treatment effects and unit costs. RESULTS: Current coverage was around 40% for most disorders with the exception of social phobia at 21%. Receipt of interventions consistent with evidence-based care ranged from 32% of those in contact with services for social phobia to 64% for post-traumatic stress disorder. The cost of this care was estimated at dollar 400 million, resulting in a cost per YLD averted ranging from dollar 7761 for generalized anxiety disorder to dollar 34 389 for panic/agoraphobia. Under optimal care, costs remained similar but health gains were increased substantially, reducing the cost per YLD to < dollar 20 000 for all disorders. CONCLUSIONS: Evidence-based care for anxiety disorders would produce greater population health gain at a similar cost to that of current care, resulting in a substantial increase in the cost-effectiveness of treatment.
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“Although effective behavioral and pharmacological interventions exist, many people struggling with SAD experience ongoing symptoms following treatment (16, 167) or do not present for treatment (5) indicating room for innovation in SAD treatment strategies.”
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“While antidepressants are certainly effective for all 4 anxiety disorders, evidence-based psychotherapies, such as cognitive–behavioral therapy, are equally or more effective, are considered first-line treatment in some (but not all) clinical guidelines, and should strongly be considered if initial treatment with medi…”
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“This is relevant to policy makers in terms of reducing population burden as current treatments are shown to be more cost-effective for mild and moderate cases than for severe cases (Issakidis et al. 2004).”
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“Only 30–40% received a treatment likely to be effective (Issakidis and Andrews, 2002; Issakidis et al., 2004).”
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“In a series of elegant cost-effectiveness modeling papers, investigators have shown that society would benefit from applying healthcare funds to improving care for anxiety disorders.(12,13) Anxiety disorders, particularly panic disorder and posttraumatic stress disorder, are associated with increased healthcare costs,…”
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“For instance, if optimal evidence based treatment were available and a conservative 50% to a maximum 90% [8,9] respond sufficiently in order to participate in vocational rehabilitation, then demand for labour force participation could increase to 40–72% of controls (50–90% of the 80% participation rate among controls).”
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“In light of the high prevalence and associated disability of GSAD, and observations that few patients with social phobia currently receive evidence-based therapies ( Issakidis et al. 2004; Stein et al. 2004), these and other potential strategies to improve outcomes should be the subject of further controlled study.”
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“Evidence-based psychotherapies, such as cognitive–behavioural therapy (CBT), are at least as effective as pharmacotherapy and should be considered, especially if initial treatment with medications proves inadequate (Issakidis et al. 2004; Butler et al. 2006).”
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von der Warth, R., Dams, J., Grochtdreis, T., & König, H. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2020.1753940 · Cited by 106
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“for the equivalent of a standard deviation change in severity, and these have been calculated for different mental disorders including social phobia [23].”
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“A third Australian study evaluated cost-effectiveness of treatment for children and adolescents with MDD (42).”
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The Effects of Mindfulness-Based Stress Reduction for Family Caregivers: Systematic Review
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On the economics of post-traumatic stress disorder among first responders in Canada
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Should Burden of Disease Estimates Include Cannabis Use as a Risk Factor for Psychosis?
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Using the effect size to model change in preference values from descriptive health status
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MethodReducing the burden of affective disorders: is evidence-based health care affordable?
Sanderson, K. A., Andrews, G., Corry, J., & Lapsley, H. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00134-4 · Cited by 45
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“In 2004, Issakidis et al. (2004) evaluated the cost-effectiveness of moving from current practice to evidence-based practice (defined as cognitive behavioural therapy (CBT) and pharmacotherapy) for anxiety disorders (including PTSD) within the Australian context.”
BackgroundWho Treats whom? An Application of the Pathways to Care Model in Australia
Issakidis, C., & Andrews, G. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2006.01746.x · Cited by 37
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Titov, N., Dear, B. F., Johnston, L., & Terides, M. D. (2012) · Revista de Psicopatología y Psicología Clínica · Cited by 31
Health–economic benefits of treating trauma in psychosis
de Bont, P. A. J. M., van der Vleugel, B. M., van den Berg, D. P. G., de Roos, C., Lokkerbol, J., Smit, F., de Jongh, A., van der Gaag, M., & van Minnen, A. (2019) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1565032 · Cited by 29
“Cognitive behavioural therapy (CBT) has favourable economic evaluations for anxiety disorders (Issakidis et al., 2004; Mihalopoulos, Baxter, Whiteford, & Vos, 2014) and PTSD (Mihalopoulos et al., 2015), but was not examined in psychotic PTSD populations.”
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Associations Between Social Anxiety and Emotional Intelligence Within Clinically Depressed Patients
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“Given social and general anxiety are often observed in patients with clinical depression and the prevalence of this disorder [9], research concerning the various linkages between emotion processing ability, anxiety and depression is required [18].”
The co-occurrence of anxiety disorders in African American parents and their children
Chapman, L. K., Petrie, J., Vines, L., & Durrett, E. L. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.08.014 · Cited by 24
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“seeking is compounded by the fact that many who do seek help do not receive effective treatment [7,50,118].”
BackgroundEvidence-based care for alcohol use disorders is affordable.
Corry, J., Sanderson, K. A., Issakidis, C., Andrews, G., & Lapsley, H. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.521 · Cited by 16
Cost-effectiveness of a randomized trial to treat depression among Latinos.
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“Anxiety and depression are the most common mental problems encountered in primary care [18,24].”
BackgroundEpidemiology and Natural Course
Beesdo‐Baum, K., & Knappe, S. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch3 · Cited by 12
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“Although effective behavioral and pharmacological interventions exist, many people struggling with SAD experience ongoing symptoms following treatment (16, 167) or do not present for treatment (5) indicating room for innovation in SAD treatment strategies.”
BackgroundHerring, M. P., Rasmussen, C. L., McDowell, C. P., Gordon, B. R., Kenny, R. A., & Laird, E. J. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.115723 · Cited by 18
“In Germany, the annual cost per person with GAD is estimated to be € 1864.6; whereas, in Australia, the total estimated medical care costs are $112.3 million (AUD) (Jacobi et al., 2002; Issakidis et al., 2004).”
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Lawrence, R. E., Rasinski, K. A., Yoon, J. D., & Curlin, F. A. (2012) · Anxiety Stress & Coping · doi:10.1080/10615806.2012.752461 · Cited by 11
“…that only half of patients who meet conventional diagnostic criteria for an anxiety disorder are treated (Fifer et al., 1994; Harman et al., 2002; Issakidis et al., 2004; Kroenke et al., 2007; Linden et al., 1999; Olfson et al., 2000; Stein et al., 2004; Wang et al., 2002; Weisberg et al., 2007;…”
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Are male and female responses to social phobia diagnostic criteria comparable?
Crome, E., Baillie, A., & Taylor, A. (2012) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1363 · Cited by 9
Cost-effectiveness analysis of guidelines for antihypertensive care in Finland
Booth, N., Jula, A., Aronen, P., Kaila, M., Klaukka, T., Kukkonen-Harjula, K. T., Reunanen, A., Rissanen, P., Sintonen, H., & Mākelä, M. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-172 · Cited by 9
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Who treats whom? An application of the Pathways to Care model in Australia
Issakidis, C., & Andrews, G. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.2006.01746.x · Cited by 8
Opportunities for Cost-effective Prevention of Late-Life Depression
Smit, F., Ederveen-Grochowska, A., Cuijpers, P. J., Deeg, D. J. H., & Beekman, A. T. F. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.3.290 · Cited by 200
Cost-utility analysis of the UPRIGHT intervention promoting resilience in adolescents
Mar, J., Larrañaga, I., Ibarrondo, O., González-Pinto, A. M., Hayas, C. L., Fullaondo, A., Izco-Basurko, I., Alonso, J., Zorrilla, E. P., Fernández-Sevillano, J., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04665-4 · Cited by 6
“We chose to measure QALYs instead of disability-adjusted life years [19] or years lived with disability [20] because the cost per QALY or incremental cost-utility ratio (ICUR) is the format used to establish standard willingness-to-pay thresholds in the economic evaluation of interventions [21, 22].”
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Op zoek naar een kosteneffectieve Basis GGZ: scenario’s voor zorginnovatie.
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“The focus of these is largely on particular therapies, and also a number of studies combining data on costs and ‘health gain’, in the context of ‘current’ and ‘optimal’ treatments.(18,31,32)”
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“Despite the high prevalence and significant morbidity, many adolescents with undiagnosed anxiety disorders may wait years before receiving appropriate treatment, resulting in higher morbidity and high social and economic costs [9,13,14].”
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“An Australian study determined that treating anxiety patients according to standard guidelines reduced direct costs, thus increasing cost-effectiveness compared with current care [38].”
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“On the basis of health economic analyses, some authors suggest that the cost-effectiveness of psychiatric services could be significantly improved by shifting resources from the current mix of interventions to evidence-based optimal treatment strategies (10-13).”
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BackgroundAdditional file 5 of Cost-effectiveness analysis of guidelines for antihypertensive care in Finland
Booth, N., Jula, A., Aronen, P., Kaila, M., Klaukka, T., Kukkonen-Harjula, K., Reunanen, A., Rissanen, P., Sintonen, H., & Mäkelä, M. (2021) · Figshare · doi:10.6084/m9.figshare.15079829
Additional file 8 of Cost-effectiveness analysis of guidelines for antihypertensive care in Finland
Booth, N., Jula, A., Aronen, P., Kaila, M., Klaukka, T., Kukkonen-Harjula, K., Reunanen, A., Rissanen, P., Sintonen, H., & Mäkelä, M. (2021) · Figshare · doi:10.6084/m9.figshare.15079838
Metadata
- Authors
- ISSAKIDIS, C., SANDERSON, K., CORRY, J., ANDREWS, G., & LAPSLEY, H.
- Affiliations
- UNSW Sydney (AU)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2004-01
- Volume
- 34
- Issue
- 1
- Pages
- 19-35
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2036167557
- Cited by
- 110
- References
- 37
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 3 · 2021: 10 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 1 · 2016: 5 · 2015: 3 · 2014: 8 · 2013: 4 · 2012: 9
- FWCI
- 26.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- Figshare (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- anxiety disorders, cost-effectiveness, evidence-based treatment, years lived with disability, disability burden, generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, treatment costs
- MeSH terms
- Anxiety Disorders, Australia, Cost-Benefit Analysis, Humans, Mental Health Services, Monte Carlo Method, Anti-Anxiety Agents, Cognitive Behavioral Therapy, Health Care Costs, Models, Econometric, Cost of Illness, Quality-Adjusted Life Years, Evidence-Based Medicine
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