{"version":"sf-huckleberry-counseling-cea-v1","reviewedAt":"2026-09-07","organization":"Huckleberry Youth Programs","program":"Modeled adolescent anxiety counseling","confidence":"very-low","denominator":"10 incremental QALYs","formula":"10 * costPerOfferedCourse / (trialQalys * transferRetention * additionality)","scope":"A proposed brief behavioral course for adolescents with anxiety, not all Huckleberry services or a claim that the exact trial protocol is delivered","scenarios":[{"name":"Optimistic positive","costPerOfferedCourse":1600,"trialQalys":0.046,"transferRetention":0.75,"additionality":0.75},{"name":"Central analyst estimate","costPerOfferedCourse":2400,"trialQalys":0.026,"transferRetention":0.5,"additionality":0.5},{"name":"Pessimistic positive","costPerOfferedCourse":4000,"trialQalys":0.009,"transferRetention":0.25,"additionality":0.25}],"judgments":[{"key":"costPerOfferedCourse","label":"Cost per offered course","basis":"Analyst nominal USD budget: twelve 45-minute sessions plus three hours of engagement/supervision = twelve hours at an assumed $200 all-in rate. Not an observed Huckleberry cost, inflation adjustment, or price quote. Includes noncompletion effort."},{"key":"trialQalys","label":"External incremental QALYs","basis":"Lynch 2021 Table 3: adjusted HUI2 difference .026 over 32 weeks, 95% CI .009–.046, brief behavioral therapy versus assisted referral. Endpoint already integrates follow-up and assignment/noncompletion; no extra duration or completion factor."},{"key":"transferRetention","label":"Local program/population transfer","basis":"50% judgment for older local recipients, protocol and setting differences. Restricted to a plausible adolescent anxiety slice; not extrapolated to acute crises, substance dependence or all trauma counseling."},{"key":"additionality","label":"Donor additionality","basis":"50% judgment for alternative access and funding substitution. Medi-Cal and state-supported care exist; no claim that half of any actual gift is additional."}],"nullBoundary":"No additional effective care means no finite positive price. Positive scenarios combine trial endpoints with subjective inputs; they are not confidence intervals for Huckleberry. Harm and long-term effects are unmodeled.","fundingRoom":{"verifiedUsd":null,"status":"unverified","nextEvidence":"Local protocol, age/diagnosis cohort, staff time, reimbursement, waiting list and priced additional course capacity."},"excluded":["Long-term health beyond 32 weeks","Family, education and justice outcomes","Societal healthcare savings","Shelter, sexual-health and other Huckleberry programs"],"sources":[{"publisher":"Huckleberry Youth Programs","title":"Counseling Programs","url":"https://www.huckleberryyouth.org/counseling-programs/","published":"Undated; relative-year language not treated as current contract date","retrieved":"2026-09-07","sourceType":"SF service identity, sliding scale and Medi-Cal provision; not marginal costs"},{"publisher":"Lynch et al., JAMA Network Open","title":"Cost-effectiveness of Brief Behavioral Therapy for Pediatric Anxiety and Depression in Primary Care","url":"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777443","published":"2021-03-15","retrieved":"2026-09-07","sourceType":"External randomized trial economic analysis; direct HUI2 outcome, not local causal evidence"},{"publisher":"Huckleberry Youth Programs","title":"Our Mission in Action","url":"https://www.huckleberryyouth.org/our-mission-in-action/","published":"2025 year-end; exact date unavailable","retrieved":"2026-09-07","sourceType":"Aggregate self-reported outcome context; not model effect input"}],"evaluatedScenarios":[{"name":"Optimistic positive","costPerOfferedCourse":1600,"trialQalys":0.046,"transferRetention":0.75,"additionality":0.75,"qalysPerOfferedCourse":0.025875000000000002,"costPerTenQalys":618357.4879227052,"additionalQalys":1.6171875000000002},{"name":"Central analyst estimate","costPerOfferedCourse":2400,"trialQalys":0.026,"transferRetention":0.5,"additionality":0.5,"qalysPerOfferedCourse":0.0065,"costPerTenQalys":3692307.6923076925,"additionalQalys":0.2708333333333333},{"name":"Pessimistic positive","costPerOfferedCourse":4000,"trialQalys":0.009,"transferRetention":0.25,"additionality":0.25,"qalysPerOfferedCourse":0.0005625,"costPerTenQalys":71111111.11111112,"additionalQalys":0.014062499999999999}]}