Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients

Abstract

BackgroundDepression causes a large burden of disease worldwide. Effective prevention has the potential to reduce that burden considerably. This study aimed to investigate the cost-effectiveness of minimal contact psychotherapy, based on Lewinsohn's ‘Coping with depression’ course, targeted at opportunistically screened individuals with sub-threshold depression.Methods and ResultsUsing a Markov model, future health effects and costs of an intervention scenario and a current practice scenario were estimated. The time horizon was five years. Incremental cost-effectiveness ratios were expressed in euro per Disability Adjusted Life Year (DALY) averted. Probabilistic sensitivity analysis was employed to study the effect of uncertainty in the model parameters. From the health care perspective the incremental cost-effectiveness ratio was € 1,400 per DALY, and from the societal perspective the intervention was cost-saving. Although the estimated incremental costs and effects were surrounded with large uncertainty, given a willingness to pay of € 20,000 per DALY, the probability that the intervention is cost-effective was around 80%.ConclusionThis modelling study showed that opportunistic screening in primary care for sub-threshold depression in combination with minimal contact psychotherapy may be cost-effective in the prevention of major depression.

Improving the Cost-Effectiveness of a Healthcare System for Depressive Disorders by Implementing Telemedicine: A Health Economic Modeling Study

“…This finding is consistent with other modeling studies on prevention [12, 44] and e-health [45]. Given the rising demand for health care and the corresponding increase in health care expenditure, preventive telemedicine could play an important role, especially so in graying societies where access to the Internet is available to almost all citizens.…”

Preventing Depression in Adults With Subthreshold Depression: Health-Economic Evaluation Alongside a Pragmatic Randomized Controlled Trial of a Web-Based Intervention

“…In addition, some evidence indicates that bibliotherapeutic self-help interventions for the prevention of depression represent good value-for-money [15]. However, economic evaluations in the field of depression prevention mainly relied on health-economic modelling [12,13,42] with direct evidence stemming only from 2 randomized controlled trials [10,11]. Although some trial-based economic evaluations of computerized cognitive-behavioral interventions for treating depressive symptoms exist (ie,) [43,44], to our knowledge, this is the first trial-based economic evaluation of a Web-based intervention to prevent the onset of major depression in an adult population with sD.…”

“…However, research on the cost-effectiveness of depression prevention is still limited. Economic evaluations conducted alongside randomized trials and economic evaluation studies using decision analytic modeling techniques suggest that preventive interventions for depression can be very cost-effective [10-13]. Research on how to deliver such interventions on a large scale to the community is scant.…”

Effect of aqueous extract and fractions of Zhi-Zi-Hou-Pu decoction against depression in inescapable stressed mice: Restoration of monoamine neurotransmitters in discrete brain regions

“…It ranks third on the list of leading causes of burden of disease, causing over four percent of all disability adjusted life years (van den Berg et al, 2011). Medications such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) are commonly used antidepressants in clinical treatment.…”