Healthcare decision makers require accurate long-term economic models to evaluate the cost-effectiveness of new mental health interventions.

To assess the suitability of current patient-level economic models to estimate long-term economic outcomes in severe mental illness.

We undertook pre-specified systematic searches in MEDLINE, Embase and PsycINFO to identify reviews and stand-alone publications of economic models of interventions for schizophrenia, bipolar disorder and major depressive disorder (PROSPERO: CRD42020158243). We screened paper titles and abstracts to identify unique patient-level economic models. We conducted a structured extraction of identified models, recording the presence of key predefined model features. Model quality and validation were appraised using the 2014 ISPOR and 2016 AdViSHE model checklists.

We identified 15 unique patient-level models for psychosis and major depressive disorder from 1481 non-duplicate records. Models addressed schizophrenia (n = 6), bipolar disorder (n = 2) and major depressive disorder (n = 7). The predominant model type was discrete event simulation (n = 9). Model complexity and incorporation of patient heterogeneity varied considerably, and only five models extrapolated costs and outcomes over a lifetime horizon. Key model parameters were often based on low-quality evidence, and checklist quality assessment revealed weak model verification procedures.

Existing patient-level economic models of interventions for severe mental illness have considerable limitations. New modelling efforts must be supplemented by the generation of good-quality, contemporary evidence suitable for model building. Combined effort across the research community is required to build and validate economic extrapolation models suitable for accurately assessing the long-term value of new interventions from short-term clinical trial data.

医疗保健决策者需要准确的长期经济模型来评估新的心理健康干预措施的成本效益。

评估当前患者层面的经济模型是否适合估计严重精神疾病的长期经济结果。

我们在 MEDLINE、Embase 和 PsycINFO 中进行了预先指定的系统搜索，以确定精神分裂症、双相情感障碍和重度抑郁症干预经济模型的评论和独立出版物 (PROSPERO: CRD42020158243)。我们筛选了论文标题和摘要，以确定独特的患者级经济模型。我们对已识别模型进行了结构化提取，记录了关键预定义模型特征的存在。使用 2014 ISPOR 和 2016 AdViSHE 模型清单评估模型质量和验证。

我们从 1481 份非重复记录中确定了 15 个独特的精神病和重度抑郁症患者级模型。模型涉及精神分裂症 ( n = 6)、双相情感障碍 ( n = 2) 和重度抑郁症 ( n = 7)。主要的模型类型是离散事件模拟（n = 9）。模型复杂性和患者异质性的结合差异很大，只有五个模型推断了一生中的成本和结果。关键模型参数通常基于低质量证据，清单质量评估显示模型验证程序薄弱。

现有的针对严重精神疾病的患者层面的经济干预模型具有相当大的局限性。新的建模工作必须通过生成适合模型构建的高质量、当代证据来补充。需要整个研究界共同努力，建立和验证经济推断模型，以根据短期临床试验数据准确评估新干预措施的长期价值。