A cost-effectiveness analysis of school-based suicide prevention programmes

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Ahern, Susan
Burke, Lee-Ann
McElroy, Brendan
Corcoran, Paul
McMahon, Elaine M.
Keeley, Helen
Carli, Vladimir
Wasserman, Camilla
Hoven, Christina W.
Sarchiapone, Marco
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Springer Verlag
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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. Trial registration number DRKS00000214.
Suicide attempt , Suicidal ideation , Prevention , Intervention , Adolescents , School , Cost-effectiveness
Ahern, S., Burke, L.-A., McElroy, B., Corcoran, P., McMahon, E. M., Keeley, H., Carli, V., Wasserman, C., Hoven, C. W., Sarchiapone, M., Apter, A., Balazs, J., Banzer, R., Bobes, J., Brunner, R., Cosman, D., Haring, C., Kaess, M., Kahn, J.-P., Kereszteny, A., Postuvan, V., Sáiz, P. A., Varnik, P. and Wasserman, D. (2018) 'A cost-effectiveness analysis of school-based suicide prevention programmes', European Child & Adolescent Psychiatry, 27, pp. 1295-1304, doi:10.1007/s00787-018-1120-5
© Springer-Verlag GmbH Germany, part of Springer Nature 2018. This is a post-peer-review, pre-copyedit version of an article published in European Child & Adolescent Psychiatry. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00787-018-1120-5