No abstract

de Graaf R, ten Have M, Beekman A. Economic costs of minor depression: a population-based study.Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n ¼ 5504) the costs of minor depression were compared with the costs of major depression and dysthymia. Excess costs, i.e. the costs of a disorder over and above the costs attributable to other illnesses, were estimated with help of regression analysis. The direct medical costs, the direct non-medical costs and the indirect non-medical costs were calculated. The year 2003 was used as the reference year. Results: The annual per capita excess costs of minor depression were US$ 2141 (95% CI ¼ 753-3529) higher than the base rate costs of US$ 1023, while the costs of major depression were US$ 3313 (95% CI ¼ 1234-5390) higher than the base rate. The costs of minor depression per 1 million inhabitants were 160 million dollars per year, which is somewhat less than the costs of major depression (192 million dollars per year). Conclusion:The economic costs associated with minor depression are considerable and approach those of major depression. Significant outcomes • The annual excess per capita costs of minor depression are about two-thirds of the per capita costs of major depression.• Per million inhabitants the excess costs of minor depression (US$ 160 million) approach those of major depression (US$ 192 million).• Virtually all excess costs of minor depression are indirect non-medical costs (costs for treatment are not significantly higher than the base rate). Limitations• The definition of minor depression was not exactly the same as the DSM-IV definition.• Although the number of subjects was large, it is relatively small for economic studies.• Data from the second measurement point of the study were used, at which point some attrition had already taken place.

This probabilistic model-based economic evaluation demonstrates how clinical trial data can be combined and integrated with country-specific information about resource utilization and unit cost to assess the cost-effectiveness of bronchodilators in COPD patients. Quality-adjusted life months did not substantially differ between treatment groups. In terms of exacerbations, tiotropium was associated with maximum expected net benefit for plausible values of the ceiling ratio. In sensitivity analyses, this outcome was most sensitive to changes in exacerbation rates.