Cost-utility of collaborative care for major depressive disorder in primary care in the Netherlands
Goorden,M. Huijbregts,K.M. van Marwijk,H.W.J. Beekman,A.T. van der Feltz-Cornelis,C.M. Hakkaart-van Roijen,L.
Goorden,M.
Huijbregts,K.M.
van Marwijk,H.W.J.
Beekman,A.T.
van der Feltz-Cornelis,C.M.
Hakkaart-van Roijen,L.
Abstract
Objective Major depression is a great burden on society, as it is associated with high disability/costs. The aim of this study was to evaluate the cost-utility of Collaborative Care (CC) for major depressive disorder compared to Care As Usual (CAU) in a primary health care setting from a societal perspective. Methods A cluster randomized controlled trial was conducted, including 93 patients that were identified by screening (45-CC, 48-CAU). Another 57 patients were identified by the GP (56-CC, 1-CAU). The outcome measures were TiC-P, SF-HQL and EQ-5D, respectively measuring health care utilization, production losses and general health related quality of life at baseline three, six, nine and twelve months. A cost-utility analysis was performed for patients included by screening and a sensitivity analysis was done by also including patients identified by the GP. Results The average annual total costs was €1131 (95% C.I., €− 3158 to €750) lower for CC compared to CAU. The average quality of life years (QALYs) gained was 0.02 (95% C.I., − 0.004 to 0.04) higher for CC, so CC was dominant from a societal perspective. Taking a health care perspective, CC was less cost-effective due to higher costs, €1173 (95% C.I., €− 216 to €2726), of CC compared to CAU which led to an ICER of 53,717 Euro/QALY. The sensitivity analysis showed dominance of CC. Conclusion The cost-utility analysis from a societal perspective showed that CC was dominant to CAU. CC may be a promising treatment for depression in the primary care setting. Further research should explore the cost-effectiveness of long-term CC. Keywords: Cost utility, Primary health care, Depressive disorder, Collaborative care, Randomized controlled trial
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2015
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Research Projects
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Goorden, M, Huijbregts, K M, van Marwijk, H W J, Beekman, A T, van der Feltz-Cornelis, C M & Hakkaart-van Roijen, L 2015, 'Cost-utility of collaborative care for major depressive disorder in primary care in the Netherlands', Journal of Psychosomatic Research, vol. 79, no. 4, pp. 316-323. https://doi.org/10.1016/j.jpsychores.2015.06.006