A cost-effectiveness estimation of the Attempted Suicide Short Intervention Programme (ASSIP)

Patients who have previously attempted suicide are at a substantially increased risk of a repeated attempt. We have conducted a cost-utility analysis of the Attempted Suicide Short Intervention Programme (ASSIP) and compared it with treatment as usual in a Flemish population. A closed-cohort Markov-model was used to simulate suicide over a time-horizon of 20 years in a cohort of prior suicide attempt patients. This model is used to estimate Incremental Cost Effectiveness Ratios (ICERs) from societal and healthcare perspectives. A separate ‘tipping-point’ scenario was included, where the treatment effectiveness regresses over time. ASSIP is shown to be a dominant strategy from the societal perspective and cost-effective from a healthcare perspective: the ICER after 10 years is € 1,133 and after 20 years € 304. In the tipping-point scenario, an regression of up to 82,7% after the intervention remains cost-effective, assuming an ICER threshold of € 44000 per QALY. Our study found that ASSIP is cost-effective in the Flemish region, saving both healthcare costs and societal expenses over time. Implementing ASSIP could provide significant economic and health benefits within 10 years, making it a valuable investment for improving mental health care.