Title

Cost-utility analysis studies of depression management: a systematic review

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date

12-1-2004

Document Type

Article

Subjects

Adult; Aged; Antidepressive Agents; Cost-Benefit Analysis; Costs and Cost Analysis; Depressive Disorder; Disease Management; Drug Costs; Female; Health Services Research; Humans; Male; Middle Aged; Psychotherapy; *Quality of Life; *Quality-Adjusted Life Years

Disciplines

Biostatistics | Epidemiology | Health Services Research

Abstract

OBJECTIVE: Depression is common, costly, treatable, and a major influence on quality of life. Cost-utility analysis combines costs with quantity and quality of life into a metric that is meaningful for studies of interventions or care strategies and is directly comparable to measures in other such studies. The objectives of this study were to identify published cost-utility analyses of depression screening, pharmacologic treatment, nonpharmacologic therapy, and care management; to summarize the results of these studies in an accessible format; to examine the analytic methods employed; and to identify areas in the depression literature that merit cost-utility analysis.

METHOD: The authors selected articles regarding cost-utility analysis of depression management from the Harvard Center for Risk Analysis Cost-Effectiveness Registry. Characteristics of the publications, including study methods and analysis, were examined. Cost-utility ratios for interventions were arranged in a league table.

RESULTS: Of the 539 cost-utility analyses in the registry, nine (1.7%) were of depression management. Methods for determining utilities and the source of the data varied. Markov models or cohort simulations were the most common analytic techniques. Pharmacologic interventions generally had lower costs per quality-adjusted life year than nonpharmacologic interventions. Psychotherapy alone, care management alone, and psychotherapy plus care management all had lower costs per quality-adjusted life year than usual care. Depression screening and treatment appeared to fall within the cost-utility ranges accepted for common nonpsychiatric medical conditions.

CONCLUSIONS: There is a paucity of literature on cost-utility analysis of depression management. High-quality cost-utility analysis should be considered for further research in depression management.

Rights and Permissions

Citation: Am J Psychiatry. 2004 Dec;161(12):2155-62. Link to article on publisher's site

Journal/Book/Conference Title

The American journal of psychiatry

PubMed ID

15569883

Related Resources

Link to Article in PubMed