# 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.

## Key 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.