Background Cost-effectiveness analysis needs to be considered when introducing new tools and treatments to clinical services. The number of new assessment tools in mental health has rapidly expanded, including in suicide risk assessment. Such suicide-based assessments, when linked to preventative interventions, are integral to high quality mental health care for people with severe mental illness (SMI). We examined the cost implications of implementing OXMIS, an evidence-based, scalable suicide risk assessment tool that provides probabilistic estimates of suicide risk over 12 months for people with SMI in England. Methods We developed a decision analytic model using secondary data to estimate the potential cost- effectiveness of incorporating OxMIS into clinical decision-making in secondary care as compared to usual care. Cost-effectiveness was measured in terms of costs per quality adjusted life years (QALYs) gained. Uncertainty was addressed with deterministic and probabilistic sensitivity analysis. Results Conducting suicide risk assessment with OxMIS was potentially cheaper than clinical risk assessment alone by £250 (95% confidence interval, -786;31) to f599 (-1,321;-156) (in 2020-2021 prices) per person with SMI and associated with a small increase in quality of life (0.01 (-0.03;0.05) to 0.01 QALY, (-0.04;0.07)). The estimated incremental cost-effectiveness ratio of implementing OxMIS was cost saving. Using probabilistic sensitivity analysis, 99.96% of 10,000 simulations remained cost saving. This peer-reviewed article has been accepted for publication but not yet copyedited or typeset, and so may be subject to change during the production process. The article is considered published and may be cited using its DOl. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by- nc-nd/4.01), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited.
Language: en
", language="en", issn="0924-9338", doi="10.1192/j.eurpsy.2022.2354", url="http://dx.doi.org/10.1192/j.eurpsy.2022.2354" }