Cost-effectiveness and affordability of interventions, policies, and platforms for the prevention and treatment of mental, neurological, and substance use disorders

Abstract

Since the turn of the millennium, considerable progress has been made in developing an evidence base on which interventions are effective and feasible for improving mental health in low- and middle-income countries (LMICs). Such evidence provides a critical input to the formulation of plans and priorities to address the large and growing burden of mental, neurological, and substance use (MNS) disorders. However, for successful and sustainable scale-up of effective interventions and innovative service delivery strategies, decision makers require not only evidence of an intervention’s impact on health and other outcomes, such as equity or poverty, but also evidence of its cost and cost-effectiveness. Cost data provide information relevant to the financial planning and implementation of prioritized, evidence-based strategies; cost-effectiveness analysis indicates the relative efficiency or value for money associated with interventions or innovations.The application of economic evaluation to MNS disorders has largely focused on the assessment of a specific intervention’s costs and health outcomes, relative to some comparator, which may be treatment as usual, another innovation, or no intervention. Such assessments have often been conducted alongside clinical trials, enabling health economic researchers to add resource use questions to study protocols, generate estimates of each trial participant’s health care costs, and relate these costs to primary outcome measures in the form o…