Cost-effectiveness of a victim improvement package: randomised controlled trial for reduction of continued symptoms of depression or anxiety in older victims of community crime

TL;DR

This study evaluated a victim improvement package for reducing depression and anxiety in older crime victims but found it was not cost-effective.

Contribution

The study introduces a randomized trial assessing a victim improvement package's cost-effectiveness for mental health outcomes in older crime victims.

Findings

The VIP intervention had a mean cost of £1330 per participant.

VIP failed to improve quality of life compared to treatment as usual.

The VIP intervention was not found to be cost-effective based on QALY differences.

Abstract

Crime has significant impact on older victims. High rates of anxiety and depression may be associated with crimes.

This paper aims to evaluate the cost-effectiveness of a victim improvement package (VIP) for the reduction of continued symptoms of depression or anxiety in older victims of community crime, from the societal perspective, in a three-step, parallel-group, single-blind randomised controlled trial.

Participants (N = 131) were randomised to receive either the VIP intervention in addition to treatment as usual (TAU) (n = 65), or to TAU alone (n = 66). Service resource use was collected using the Client Service Receipt Inventory and health-related quality-of-life data via the EQ-5D-5L instrument at 3 months post-crime (baseline), 6 months post-crime (post-intervention) and 9 months post-crime (follow-up).

The mean cost of the VIP intervention was estimated at £1330 per participant in the intervention arm. The mean difference in costs between the VIP and TAU arms over the 6-month trial duration was −£881 (95% CI: −£5947 to £4186). The mean difference in quality-adjusted life-years (QALYs) was −0.011 (95% CI: −0.042 to 0.020).

The addition of VIP to TAU for older victims of community crime generated a lower mean point estimate for costs, and failed to improve quality of life compared with TAU alone. While this places VIP in the south-west quadrant of the cost-effectiveness plane, the magnitude and significance of the QALY difference do not justify declaring VIP cost-effective or TAU not cost-effective. Future research is needed to identify the most cost-effective intervention.

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