TABLE 112HEALTH ECONOMICS EVIDENCE

Study ID and countryIntervention detailsStudy population
Setting Study design – data source
Study typeCosts: description and values
Outcomes: description and values
Results: cost effectivenessComments
Internal validity (Yes/No/NA)
Industry support
KUTCHER 1995, CanadaIntervention:
ECT (2 sessions per week, brief pulse method)
Comparator:
Standard pharmacological inpatient care
Adolescents and young adults (ages 16–22) with treatment-resistant acute bipolar episodes (either manic or depressive)
Tertiary care
Data source of effect size measures and resource use: retrospective comparative study; groups defined by self-selection 22 patients eligible for ECT; 16 agreed (ECT group) and 6 denied (control group). Proportion of manic and depressive acute episodes within each group: 1:1
Cost-consequences analysisCosts:
Hospital
Resource use estimated: length of hospital stay
Average cost per admission:
ECT $58,608
Control group $143,264
Outcomes:
Improvement in BPRS scores
Side effects of ECT
Length of hospitalisation
BPRS: significant improvement overtime for both groups:
ECT group p < 0.0001, control group p = 0.001
ECT group significantly lower BPRS scores at discharge than control group (p < 0.03)
Side effects of ECT: generally mild, in 28% of the 166 ECT sessions.
Length of hospital stay (mean): ECT group 73.8 days, control group 176 days
Not applicablePerspective: hospital
Currency: Canadian $
Cost year: not reported
Discounting: not needed
Time horizon: until hospital discharge following an acute manic or depressive episode
Internal validity: 12/9/14

From: APPENDIX 14, HEALTH ECONOMICS EVIDENCE TABLES

Cover of Bipolar Disorder
Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care.
NICE Clinical Guidelines, No. 38.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2006.
Copyright © 2006, The British Psychological Society & The Royal College of Psychiatrists.

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