EA - Vida Plena Predictive Cost-Effectiveness Analysis by Samuel Dupret

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Vida Plena Predictive Cost-Effectiveness Analysis, published by Samuel Dupret on December 26, 2022 on The Effective Altruism Forum.Disclaimer: Samuel Dupret volunteered his time to develop the analysis. While Samuel is a current member of the research team of the Happier Lives Institute (HLI), this analysis is an independent project which is not part of HLI’s body of research. Joy Bittner, as the founder of Vida Plena, contributed to the report and was previously the Operations Manager at HLI. This is not a recommendation by HLI.SummaryMultiple experts have stated that mental health is one of the most neglected health issues and should urgently receive more global investment (Walker et al., 2021; WHO, 2022). According to the Global Burden of Disease (Ferrari et al., 2022), mental disorders are “the seventh leading cause” (p. 144) of health burden in the world in 2019. Of the mental health disorders, depression is the one with the highest health burden (Ferrari et al., 2022).Vida Plena (see this post for a presentation) will address the lack of treatment for depression by empowering local people to deliver a cost-effective model of psychotherapy. Community members are trained to treat depression through Group Interpersonal Therapy (g-IPT), which is recommended by the World Health Organization as a first-line treatment for depression in low-income settings (WHO, 2020). The aim of Vida Plena is to replicate in Ecuador the success of StrongMinds (which uses g-IPT in Uganda and Zambia). StrongMinds is recommended by Founders Pledge (Halstead, 2019) and is the Happier Lives Institute’s top recommendation (HLI, 2022).Potential funders of Vida Plena are interested in how much good it can accomplish. Whilst data collection and a pilot study are planned, Vida Plena has only just started so it does not have its own cost-effectiveness data. However, we can give a predictive value by using previous cost-effectiveness analyses (CEA) of StrongMinds (Halstead et al., 2019; McGuire & Plant, 2021b; McGuire et al., 2022a) and converting their results to Vida Plena’s context. We use Vida Plena’s predicted costs, the Ecuadorian average household size for spillovers, and we apply two adjustments (one for the counterfactual treatment gap and one for the probability of success). Once data from Vida Plena itself is collected, we will update the CEA.We estimate it will cost $17 to improve a recipient’s wellbeing by one wellbeing-adjusted life year (WELLBY). For a comparison, this is 8 times more cost-effective than GiveDirectly (a gold standard charity which delivers cash transfers in low- and middle-income countries).Additionally, to allow for comparisons with other health programs, we also produce a disability-adjusted life year (DALY) prediction. It is, however, our opinion that our WELLBY analysis is more robust because it includes a comprehensive evaluation beyond just physical health as well as the impact of household spillovers. Nevertheless, we estimate that it will cost Vida Plena $462 to avert one DALY.While we are not arguing that Vida Plena will be the most cost-effective endeavour, we do expect that it is potentially a very cost-effective charity that will improve human wellbeing in an neglected region - Ecuador and Latin America. No mental health organisations currently operate at scale in Latin America; hence, an important treatment gap exists (PAHO, 2018). This provides a counterfactual argument for creating a new mental health organisation specifically reaching people in the region.What’s the problem and how will Vida Plena address it?Mental illness results in reduced quality of lifeBeyond any other metric used to describe it, the core badness of mental health problems, such as depression, is that the actual lived experience is exceptionally bad. Mental health is o...