Developing a Health-Economic Model to Assess Cost-Effectiveness of Preventive Interventions for Children of Parents with Mental Illness or Substance Use Disorder
Meijer, Yara M Wijnen, Ben FM Kleijburg, Anne Valkenburg, Hendrika J de Gee, Anouk Shields-Zeeman, Laura Thielen, Frederick W
Meijer, Yara M
Wijnen, Ben FM
Kleijburg, Anne
Valkenburg, Hendrika J
de Gee, Anouk
Shields-Zeeman, Laura
Thielen, Frederick W
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2026-02-02
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Developing a Health-Economic Model to Assess Cost-Effectiveness of Preventive Interventions for Children of Parents with Mental Illness or Substance Use Disorder
Translated Title
Published in
Value Health 2026; S1098-3015(26)00034-3
Abstract
OBJECTIVE: Children of parents with a mental illness (COPMI) face a higher risk of developing mental disorders, leading to significant long-term societal and health-related costs. While preventive interventions exist, few studies assess their cost-effectiveness, and none model long-term outcomes. This study aims to develop a Markov model to evaluate the cost-effectiveness of preventive interventions for COPMI in the Netherlands.
METHODS: A decision-analytic model was constructed using data from the Avon Longitudinal Study of Parents and Children. The model simulates COPMI progression over time, with health states including: healthy, depression/anxiety, comorbidity, remission, and death. The time horizon spans 28 years, from ages 7 to 35, and outcomes are evaluated from both healthcare and societal perspectives. Results are expressed as total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). A group-based cognitive behavioral therapy (CBT) intervention was evaluated against a reference scenario.
RESULTS: The preventive CBT intervention yielded an additional 0.02 QALYs at an additional cost of €188 per patient, resulting in an ICER of €9,495 per QALY. The intervention had a 74% probability of being cost-effective at a willingness-to-pay threshold of €20,000 per QALY.
CONCLUSIONS: The Markov model provides a flexible tool for evaluating the cost-utility of user-defined COPMI interventions to support informed decision-making in mental health care. It is freely available for academic purposes upon request by the authors. Results suggest group-based CBT may be a cost-effective strategy for preventing mental disorders in COPMI.