Cost-effectiveness of a new treatment for somatized mental disorder taught to GPs

Background. Patients with mental disorder presenting with medically unexplained symptoms (somatized mental disorder) are difficult to treat and consume a lot of health care. Objectives. The aim of the study was to examine the cost-effectiveness of a training package for somatized mental disorder delivered by GPs. Methods. The study design was a prospective, before-and after-training study of different cohorts of patients attending eight GPs, acting as their own controls. Cost-effectiveness analysis was estimated using changes in case level on a self-rated psychiatric symptom questionnaire (GHQ-12) and direct health costs between the index consultation and 3 months later. Results. There were 103 and 112 patients with somatized mental disorder in the before and after training cohorts, respectively. After training, costs of referrals outside the primary care team decreased significantly by 23%, with little overall change in primary care costs. Total direct health care costs, including training, were reduced by 15%. After training, an extra 17 patients were successfully treated (no longer GHQ-12 cases) at 3 months. The marginal cost-effectiveness per extra successfully treated patient was pound 325 and the cost per successfully treated case was 69% of the cost of the GP's usual treatment. Conclusions. Training GPs with the reattribution training package appears to be extremely cost-effective.