Economic Evaluation of State Control, Low Price, and Research-Based Policy for Eating Disorders Treatment in Sweden

Introduction Porter and Olmsted Teisberg suggested that the value of healthcare should be measured by treatment outcomes related to costs. Policy should financially reward treatment effects and in an outline of value-based healthcare, they predicted: State control policy yields variable effects, increasing costs Low price policy decreases effects, increasing costs Research and Development (R&D) policy increases effects, decreasing costs Methods The treatment of eating disorders in Region Stockholm, Sweden, in years 2012-2016 makes it possible to test these predictions because a State control, a Low price, and an R&D provider were contracted and the effects and costs of their treatments are publically available from Region Stockholm. Results The State control provider was contracted to provide more care services than the other providers. The average yearly number of patients treated to remission/patients treated was 164/714 (23%) at the State control provider, 41/170 (24) at the Low price provider, and 152/192 (79%) at the R&D provider. The average yearly budget was 73 million Swedish crowns (MSEK) compared to 49 MSEK at the R&D provider and 32 MSEK at the Low price provider (on average 30% lower per care service than the two other providers). The average cost to treat a patient to remission/patients treated was highest at the Low price provider (859 KSEK), followed by the State control provider (464 KSEK) and the R&D provider (327 KSEK). Conclusions The results confirm Porter and Olmsted Teisberg’s three predictions and suggest that an R&D policy increases the value of healthcare.