Cost-Utility of Improving Access to Psychological Therapies compared with usual care in Norway: A Registry-Linked Randomised Trial
In brief
Norway's therapy program adds 0.24 quality-adjusted life-years for about EUR 6,400 each
In a randomized trial of 738 adults, Prompt Mental Health Care produced an estimated 0.24 additional quality-adjusted life-years over three years, at about EUR 6,400 per year gained. Its estimated public-sector costs were close to zero when work-related benefits were included, but the three-year results relied on modeled data for usual care, and those cost savings remain uncertain.
- Journal
- Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (Q1)
- Published
- 2 November 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Otto R F Smith, David M Clark, Jan Abel Olsen, Richard Layard, Marit Knapstad
- PMID
- 42971530
- DOI
- 10.1016/j.jval.2026.10.007
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (paper of the day, 5 November 2026): Randomized-trial economic evaluation of CBT for anxiety and depression
Abstract
OBJECTIVES: Prompt Mental Health Care (PMHC), Norway's adaptation of England's Improving Access to Psychological Therapies, provides cognitive behavioural therapy for adults with anxiety or mild-to-moderate depressive symptoms. We assessed cost-utility using registry-linked data. METHODS: This evaluation included 738 participants from a randomised trial (70:30 allocation) of PMHC versus treatment-as-usual (TAU). Registry data provided healthcare costs, prescriptions, sick leave and work assessment allowances. EQ-5D-5L was assessed through 36 months in PMHC and 12 months in TAU; TAU utilities at 24 and 36 months were model-projected. Presenteeism was assessed with the Health and Work Performance Questionnaire. Cost-utility was estimated over 1-, 2-, and 3-year horizons from healthcare and public-sector perspectives. RESULTS: Over 1 year, incremental QALYs were 0.07 (95% CI 0.05-0.10), with incremental healthcare costs of €1,710 (95% CI €1,557-€1,865), yielding an ICER of €23,809/QALY (95% CI €16,272-€38,321). Over 3 years, model-based estimates were 0.24 incremental QALYs (95% CI 0.14-0.35) and €1,551 in incremental healthcare costs (95% CI €1,266-€1,837), yielding an ICER of €6,376/QALY (95% CI €4,055-€11,533). At €30,000/QALY, cost-effectiveness probability was 84% over 1 year and ≥99% over 2 and 3 years. Incremental public-sector costs over 3 years were -€296 (95% CI -€3,588 to €2,848) when sick-leave benefits and work assessment allowances were included alongside healthcare costs. Presenteeism gains equalled 0.25 full-productivity years. CONCLUSIONS: PMHC delivered sustained health gains at modest additional healthcare cost and was likely cost-effective, with ICERs below Norwegian and UK NICE thresholds. Incremental public-sector costs were close to zero over 3 years, although uncertain.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.