Cost-effectiveness of cognitive–behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: economic evaluation of the CoBalT Trial

Hollinghurst, Sandra; Carroll, Fran; Abel, Anna; Campbell, John; Garland, Anne; Jerrom, Bill; Keßler, David; Kuyken, Willem; Morrison, Jill; Ridgway, Nicola; Thomas, Laura; Turner, Katrina; Williams, Chris; Peters, Tim J.; Wiles, Nicola

doi:10.1192/bjp.bp.112.125286

Cited by 29 publications

(38 citation statements)

References 36 publications

(52 reference statements)

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“…Personalising the choice of treatment will be critical to more efficient use of health care resources in the future (Cuijpers et al, 2012, Hollinghurst et al, 2014, Simon and Perlis, 2010, Wallace et al, 2013. Second, we would encourage the use of observational data coupled with appropriate statistical methods to gain a better understanding of the effects of depression treatment in a routine care setting and the long-term cost-effectiveness.…”

Section: Resultsmentioning

confidence: 99%

Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

et al. 2015

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Section: Resultsmentioning

confidence: 99%

Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

et al. 2015

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“…However at a willingness-to-pay of zero per unit of improvement, the probability is 24%. (Domino et al 2008;Lynch et al 2011;Maljanen et al 2012;Hollinghurst et al 2014). All studies included a well-defined research question, reported on the effectiveness of the programme or service concerned, identified all relevant costs and consequences for each alternative, measured costs and consequences accurately, and valued the cost credibly.…”

Section: Uk Societalmentioning

confidence: 99%

“…Only three studies reported on adjusting cost and consequences for differential timing (Byford et al 2007;Domino et al 2008;Maljanen et al 2012). Five studies did not make allowances for uncertainty in the estimation of costs ( Only three studies allowed for uncertainty in the estimation of consequences (Domino et al 2008;Lynch et al 2011;Hollinghurst et al 2014).…”

Section: Uk Societalmentioning

confidence: 99%

Economic evidence for the clinical management of major depressive disorder: a systematic review and quality appraisal of economic evaluations alongside randomised controlled trials

Karyotaki

Tordrup

Buntrock

et al. 2016

Epidemiol Psychiatr Sci

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There is some economic evidence underpinning many of the common treatment options for major depression. Wide variability was observed in study outcomes, probably attributable to differences in population, interventions or follow-up periods. For many interventions, only a single economic evaluation alongside clinical trials was identified. Thus, significant economic evidence gaps remain in the area of major depressive disorder.

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“…749 In 2008 Wiles published the results from a pilot trial for the CoBalT 50 study, which provided proof that they would be able to recruit the appropriate subjects for the larger HTA programme-funded CoBalT 50 RCT that followed (interviewee). 755 and an article in the British Journal of Clinical Psychiatry reflecting the findings of the nested qualitative study (interviewee).…”

Section: Appendix 44: Crash-2mentioning

confidence: 99%

The impact of the National Institute for Health Research Health Technology Assessment programme, 2003–13: a multimethod evaluation

Guthrie

Bienkowska-Gibbs

Manville

et al. 2015

Health Technol Assess

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BackgroundThe National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme supports research tailored to the needs of NHS decision-makers, patients and clinicians. This study reviewed the impact of the programme, from 2003 to 2013, on health, clinical practice, health policy, the economy and academia. It also considered how HTA could maintain and increase its impact.MethodsInterviews (n = 20): senior stakeholders from academia, policy-making organisations and the HTA programme. Bibliometric analysis: citation analysis of publications arising from HTA programme-funded research. Researchfish survey: electronic survey of all HTA grant holders. Payback case studies (n = 12): in-depth case studies of HTA programme-funded research.ResultsWe make the following observations about the impact, and routes to impact, of the HTA programme: it has had an impact on patients, primarily through changes in guidelines, but also directly (e.g. changing clinical practice); it has had an impact on UK health policy, through providing high-quality scientific evidence – its close relationships with the National Institute for Health and Care Excellence (NICE) and the National Screening Committee (NSC) contributed to the observed impact on health policy, although in some instances other organisations may better facilitate impact; HTA research is used outside the UK by other HTA organisations and systematic reviewers – the programme has an impact on HTA practice internationally as a leader in HTA research methods and the funding of HTA research; the work of the programme is of high academic quality – theHealth Technology Assessmentjournal ensures that the vast majority of HTA programme-funded research is published in full, while the HTA programme still encourages publication in other peer-reviewed journals; academics agree that the programme has played an important role in building and retaining HTA research capacity in the UK; the HTA programme has played a role in increasing the focus on effectiveness and cost-effectiveness in medicine – it has also contributed to increasingly positive attitudes towards HTA research both within the research community and the NHS; and the HTA focuses resources on research that is of value to patients and the UK NHS, which would not otherwise be funded (e.g. where there is no commercial incentive to undertake research). The programme should consider the following to maintain and increase its impact: providing targeted support for dissemination, focusing resources when important results are unlikely to be implemented by other stakeholders, particularly when findings challenge vested interests; maintaining close relationships with NICE and the NSC, but also considering other potential users of HTA research; maintaining flexibility and good relationships with researchers, giving particular consideration to the Technology Assessment Report (TAR) programme and the potential for learning between TAR centres; maintaining the academic quality of the work and the focus on NHS need; considering funding research on the short-term costs of the implementation of new health technologies; improving the monitoring and evaluation of whether or not patient and public involvement influences research; improve the transparency of the priority-setting process; and continuing to monitor the impact and value of the programme to inform its future scientific and administrative development.FundingThe NIHR HTA programme.

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Cost-effectiveness of cognitive–behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: economic evaluation of the CoBalT Trial

Abstract: The addition of CBT to usual care is cost-effective in patients who have not responded to antidepressants. Primary care physicians should therefore be encouraged to refer such individuals for CBT.

Cited by 29 publications

References 36 publications

Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

Modelling the cost-effectiveness of pharmacotherapy compared with cognitive–behavioural therapy and combination therapy for the treatment of moderate to severe depression in the UK

Economic evidence for the clinical management of major depressive disorder: a systematic review and quality appraisal of economic evaluations alongside randomised controlled trials

The impact of the National Institute for Health Research Health Technology Assessment programme, 2003–13: a multimethod evaluation

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