Cost-effectiveness of a Victim Improvement Package (VIP): A Randomised Controlled Trial for the Reduction of Continued Symptoms of Depression or Anxiety in Older Victims of Community Crime

Background : Crime has significant impact on older victims. High rates of anxiety and depression may be associated with crimes. Aims: 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. Method s : 131 participants were randomised to receive the VIP intervention in addition to treatment as usual (TAU) (n=65) or TAU alone (n=66). Service resource use was collected using the Client Service Receipt Inventory and health-related quality-of-life data using the EQ-5D-5L instrument at 3 months post crime (baseline), 6 months post crime (post intervention) and 9 months post crime (follow-up). Results: The mean cost of the VIP intervention was estimated at £1,330 per participant in the intervention arm. The mean difference in costs between the VIP and TAU arms over the 6 months trial duration was -£881 (95% CI: -£5,947 to £4,186). The mean difference in QALYs was -0.011 (95% CI: -0.042 to 0.020). Conclusions : The addition of the VIP to TAU for older people victims of community crime generated lower mean point estimate for costs and failed to improve the quality-of-life compared to TAU alone. While this places VIP on the south-west quadrant on the cost-effectiveness plane, the magnitude and significance of the QALY difference does not justify declaring VIP cost-effective or TAU not cost-effective. Future research is needed to identify the most cost-effective intervention.