Cost-effectiveness analysis of interventions to achieve universal health coverage for schizophrenia in Mexico.(ORIGINAL ARTICLE texto en ingles)

Introduction.To achieve universal coverage in mental health, it is necessary to demonstrate which interventions should be adopted. Objective. Analyze the alternatives of pharmacological and psychosocial treatment in Mexico for patients diagnosed with schizophrenia, as well as Early Intervention in Psychosis Program. Method. The Extended cost effectiveness analysis (ECEA), it is implemented under scenario the option of treatment in Mexico, which includes: typical or atypical antipsychotic medication plus psychosocial treatment, assuming that all the medications will be provided to the patient, a measure of effectiveness is the years of life adjusted to disability (DALYs). Results. The effect of Universal Public Financing (UPF) is reflected in avoiding 147 DALYs for every 1,000,000 habitants. In addition, has a positive effect in the avoided pocket expenditures from US $ 101,221 to US $ 787,498 according to the type of intervention. Increasing government spending has a greater impact on the poorest quintile, as a distributive effect of the budget is generated. Respect to the value of insurance, the quintile III is the one who is most willing to pay for having insurance, on the other hand, in the highest income quintile, the minimum assurance valuation was observed. Discussion and conclusion. Thereduction in out-of-pocket spending is uniform across all quintiles; "Early Intervention in Psychosis Program" is not viable for middle income countries, as Mexico. The ECEA is a convenient method to assess the feasibility and affordability of mental health interventions to generate information for decision makers. Keywords: Universal health coverage, schizophrenia, cost-effectiveness. Introduccion. Para lograr la cobertura universal en salud mental es necesario demostrar que intervenciones deberian ser adoptadas. Objetivo. Analizar las alternativas de tratamiento farmacologico y psicosocial para pacientescon esquizofrenia incluidas, asi como un Programa de Intervencion Temprana en Psicosis. Metodo. El analisis costo efectividad extendido (ECEA) se implemento bajo un escenario que incluye: medicacion antipsicotica tipica o atipica mas tratamiento psicosocial, asumiendo que todos los medicamentos seran provistos a los pacientes, la medicion de la efectividad en terminos de DALYs. Resultados. El efecto del financiamiento publico universal se refleja en evitar 147 DALYs por cada 1, 000,000 de habitantes. Ademas, tiene un efecto positivo en evitar pagos de bolsillo de US