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Cost-effectiveness of adherence therapy versus health education for people with schizophrenia: randomised controlled trial in four European countries

Research output: Contribution to journalArticle

Anita Patel, Paul McCrone, Morven Leese, Francesco Amaddeo, Michele Tansella, Reinhold Kilian, Matthias Angermeyer, Martijn Kikkert, Aart Schene A, Martin Knapp

Original languageEnglish
Article number12
Number of pages13
JournalCost Effectiveness and Resource Allocation
Publication statusPublished - 25 May 2013

King's Authors


Non-adherence to anti-psychotics is common, expensive and affects recovery. We therefore examine the cost-effectiveness of adherence therapy for people with schizophrenia by multi-centre randomised trial in Amsterdam, London, Leipzig and Verona.

Participants received 8 sessions of adherence therapy or health education. We measured lost productivity and use of health/social care, criminal justice system and informal care at baseline and one year to estimate and compare mean total costs from health/social care and societal perspectives. Outcomes were the Short Form 36 (SF-36) mental component score (MCS) and quality-adjusted life years (QALYs) gained (SF-36 and EuroQoL 5 dimension (EQ5D)). Cost-effectiveness was examined for all cost and outcome combinations using cost-effectiveness acceptability curves (CEACs).

409 participants were recruited. There were no cost or outcome differences between adherence therapy and health education. The probability of adherence therapy being cost-effective compared to health education was between 0.3 and 0.6 for the six cost-outcome combinations at the willingness to pay thresholds we examined.

Adherence therapy appears equivalent to health education. It is unclear whether it would have performed differently against a treatment as usual control, whether such an intervention can impact on quality of life in the short-term, or whether it is likely to be cost-effective in some sites but not others.

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