An Extended Cost-Effectiveness Analysis of Schizophrenia Treatment in India under Universal Public Finance

Authors: Neha Raykar , Aditi Nigam, Dan Chisholm

Abstact:

BACKGROUND: Schizophrenia remains a priority condition in mental health because of its early onset, severity, and the human rights violations it often inflicts on patients. It also imposes a catastrophic economic burden on patients, their families, and health care systems.

AIMS AND METHODS: This paper develops an extended cost-effectiveness analysis (ECEA) for schizophrenia treatment in India to evaluate the consequences of universal public finance (UPF) on health and financial outcomes across income quintiles.

RESULTS: Using plausible values for input parameters, we conclude that health gains from UPF are concentrated among the poorest, whereas the non-health gains in the form of out-of-pocket private expenditures averted due to UPF are concentrated among the richest income quintiles. Value of insurance is the highest for the poorest quintile and declines with income.

CONCLUSIONS: The purpose of this analysis is to locate the relative position of schizophrenia interventions within a wider extended cost-effectiveness and priority-setting framework in the health sector. This is relevant because treatment of schizophrenia is all too often regarded as overly expensive or unaffordable. UPF can play a crucial role in ameliorating the adverse economic and social consequences of schizophrenia and its treatment in resource-constrained settings where health insurance coverage is generally poor.