P57\u2005Testing the impact of IAPT on healthcare costs and employment: a step-wedge design

Abstract

Background According to the World Health Organization (WHO), depression is ranked as the single largest contributor to global disability. The Improving Access to Psychological Therapies (IAPT) programme is a large-scale initiative that aims to greatly increase the availability of NICE recommended psychological treatment for depression and anxiety disorders within the National Health Service in England. This study evaluates whether IAPT reduces healthcare utilization and associated health care costs and increases transition into employment. Methods Gradual implantation of a stepped-wedge design of two cohorts covering 500 patients with depression and/or anxiety and comorbid long-term physical health conditions from three areas in Thames Valley (Berkshire, Oxfordshire and Buckinghamshire) for the period March 2017 – August 2017. Results The wedge study findings showed a decrease in cost £345 total pp for 3 months so about £115 a month difference between the two cohorts. Results also showed a decrease by about 4.61[95% CI: -5.56, -3.66] (6.64 [95% CI: -7.67, -5.61]) [0.76 [95% CI: -1.22, -0.30]] points per person in the GAD7 (PHQ9) [WASAS]. With respect to employment, results to find a job for those who were unemployment by about 29.9% [95% CI: 1.37–52.4], the marginal effects corresponds to 6.28 percentage points [95% CI: 2.19–12.3]. Conclusion IAPT treatment was associated with a significant decline in secondary care costs and significant increase in the probability to find a job for unemployed patients. Supported by an ERC Grant 313590-HRES. Also funded by Wellcome Trust.