Abstract
BackgroundSchizophrenia remains a priority condition in mental health policy and service development because of its early onset, severity and consequences for affected individuals and households.Aims and methodsThis paper reports on an ‘extended’ cost-effectiveness analysis (ECEA) for schizophrenia treatment in India, which seeks to evaluate through a modeling approach not only the costs and health effects of intervention but also the consequences of a policy of universal public finance (UPF) on health and financial outcomes across income quintiles.ResultsUsing 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.ConclusionsUniversal public finance 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. This paper shows the potential distributional and financial risk protection effects of treating schizophrenia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12962-016-0058-z) contains supplementary material, which is available to authorized users.
Highlights
Schizophrenia remains a priority condition in mental health policy and service development because of its early onset, severity and consequences for affected individuals and households
Taking into account current debates in India about appropriate pathways towards universal health coverage, we focus in this paper on the impact of enhanced public financing and provision of schizophrenia treatment on health and financial outcomes, including increased uptake of treatment, reduced outof-pocket treatment costs and greater insurance against catastrophic health expenses
Such schemes currently exclude treatment of mental disorders and there has been no quantitative assessment of the amount of financial protection that a universal public finance (UPF) scheme can provide against schizophrenia treatment
Summary
Schizophrenia remains a priority condition in mental health policy and service development because of its early onset, severity and consequences for affected individuals and households. Taking into account current debates in India about appropriate pathways towards universal health coverage, we focus in this paper on the impact of enhanced public financing and provision of schizophrenia treatment on health and financial outcomes, including increased uptake of treatment (leading to more health gain), reduced outof-pocket treatment costs and greater insurance against catastrophic health expenses. Assessment of these various consequences provides new, evidence-based insights
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