Evaluating the cost-effectiveness of Everyday Life Rehabilitation (ELR) for individuals with serious mental illness in supported accommodation

Everyday Life Rehabilitation (ELR) is a recovery-oriented intervention that aims at improving residents’ quality of life through engagement in meaningful everyday activities. The intervention has been demonstrated to be effective in a randomized controlled trial (ClinicalTrials.gov: NCT05056415). A cost-utility analysis (CUA) was conducted using quality-adjusted life years (QALYs) derived from ReQoL-UI as the primary outcome. Both deterministic and probabilistic sensitivity analysis was used to explore critical assumptions. A budget impact analysis was used to estimate the incremental cost of scaling up ELR in routine practice. The intervention was found to be cost-effective compared to usual care, with an estimated incremental cost-effectiveness ratio (ICER) of 133 494 SEK (12 148 EUR) per QALY. Sensitivity analysis indicated that the findings were robust. The estimated average budget impact was estimated to be 10 118 SEK (921 EUR) per resident for one year of ELR. Overall, ELR demonstrated significant clinical benefits with minimal incremental costs. Throughout the analysis, we have used highly conservative estimates. Despite this, the analysis concluded that the intervention has a high probability of being cost-effective. Thus, the study provides robust evidence for the value of ELR as a scalable and economically viable intervention.