First author | Population | Accepted as CC because: | Cost measurement | Effectiveness measurement | Results |
---|---|---|---|---|---|
Von Korff et al, 1998[23] Prices based on the year: unknown | Primary care patients (US), newly diagnosed major depression (DSM-III-R), N = 153 Mean age: I = 43.1, C = 44.8 | Collaborative management, psychologist and physician, problem-solving treatment | Health care perspective Intervention costs, primary care costs Follow-up: 7 months | SCL-90 score, successfully treated case of depression | Incremental cost-effectiveness: $3741 per successfully treated case of major depression. Reduction in SCL-score (70.4% vs. 42.3%) Conclusion: strong indication for cost-effectiveness |
Simon et al, 2001a[24] Prices based on the year: 1996 | Patients not responding to 8 weeks usual care, US primary care, major depression according to DSM-IV, N = 228 Mean age: I = 45.6, C = 45.4 | Stepped care, patient education, advice to patient and physician by psychiatrist, ongoing management | Social perspective Intervention costs, non-depression primary care costs, total out-patient treatment costs, total health service costs Follow-up: 6 months | SCL-90 score, HRQoL | Incremental intervention related direct medical costs: $21 per DFD (95% CI $8 to $126) over 6 months. Total healthcare costs $35 per DFD (95% CI -$52 to $388) over 6 months. Patient costs: travelling expenses I = $1636 (95% CI 1356-1916) C = 1337 (95% CI 1174-1499) I = 50% reduction SCL score, 95% CI 1.02 - 2.03. Conclusion: strong indication for cost-effectiveness |
Simon et al, 2001b[25] Prices based on the year: unknown | High utilisers of medical care, high probability of undiagnosed major depression (DSM-IV), US primary care, N = 407. Mean age: I = 47.2, C = 46.7 | Depression management coordinated by primary care mental health worker, psychiatrist support, physician and patient education, using guidelines | Health care perspective Intervention costs, in- and outpatient depression treatment costs Follow-up: 12 months | HRSD improvement, HRQoL, | Intervention related direct medical costs $21 (95% CI $11 to $38) per DFD. HRSD: 53.2% (I) vs. 32.8% (C) shows 50% improvement after 12 months Conclusion: strong indication for cost-effectiveness |
Schoenbaum et al, 2001[26] Prices based on the year: 1998 | US primary care, major depression according to DSM-IV, N = 1356 Mean age: I = 44.5, C = 42.2 | Nurse specialists follow-up patients, conjunction between nurse - primary care physician and specialist | Health care perspective Depression primary care costs, intervention costs, costs per QALY Follow-up: 24 months | HRQoL (QALYs calculated from SF-12 and Depression burden days), CES-D | Intervention related direct medical costs by SF-12 method $21 478 per QALY (confidence interval not given). By DFD method, 95% CI $9478 to $18 953 CES-D reduction: 50% for intervention. Conclusion: strong indication for cost-effectiveness |
Liu et al, 2003[27] Prices based on the year: 2000 | Veteran population, Male = 95%, Major depression according to DSM-IV, N = 354 Mean age: I = 57.8, C = 56.6 | Patient education, progress evaluation, team meetings, stepped care | Health care perspective Total (outpatient) costs Follow-up: 9 months | SCL-90 score | DFD increment for I = 14.6 Intervention related direct medical costs: I = $615 higher, $3754 (CI 3329-4179) vs. $3139 (CI 2759 -3519). Total intervention costs: I = $1259 higher; $7946 (CI 5582-10310) vs. $6789 (CI 4720-8858). I = SCL sign. better at 3 months (P < .25) Conclusion: strong indication for cost-effectiveness |
Araya et al, 2006[28] Prices based on the year: 2004 | Females 18-70 years, major depression according to DSM-IV, N = 240 Mean age: I = 44.1 (SD 12.1) and C = 42.0 (SD 13.7) | Monitoring clinical progress, manager coordinates with physicians, stepped care | Health care perspective Costs per patient, cost-effectiveness ratio Follow-up: 6 months | HRSD score | DFD: I = 50 more. Incremental cost-effectiveness ratio = 0.75. Intervention related direct medical costs: I = $87.8 per patient (CI 78.9 - 103.4), C = $51.5 per patient (CI 43.0 - 60.5) Conclusion: cost-effective |
Katon et al, 2005[29] Prices based on the year: unknown | Diabetes, major depression according to DSM-IV, N = 1801 Mean age: I = 71, C = 71.4 | Based on IMPACT protocol, stepped care, depression care manager consults with professionals, problem-solving treatment | Health care perspective Outpatient mental health costs, costs per QALY Follow-up: 24 months | HSCL-20 improvement, QALYs | Increment in DFD 1st year: 52.6 (CI 42.2 - 63.0). Increment in DFD 2nd year: 54.3 (CI 42.2 - 66.2). Intervention related direct medical costs 2nd year follow-up = $921 higher than CAU. Costs per QALY: $2519 (95% CI -$4517 to $9554)) to $5037 (95% CI -$9034 to $19 108). Conclusion: strong indication for cost-effectiveness |
Simon et al, 2007[30] Prices based on the year: unknown | Diabetes and major depression according to DSM-IV, N = 329 Mean age: I = 58, C = 57 | Stepped care, depression nurse coordinates contacts with professionals and patient, treatment based on the IMPACT-model | Health care perspective Outpatient costs Follow-up: 24 months | SCL-90 score | Increment in DFD: I = 20 in 1st year, 33 in 2nd year. Intervention related direct medical costs costs: I = $1400 lower in 2nd year, mean I = $600 lower in 2nd year. Health services in 2 years: I = $21148 (SD 27548) vs. C = $22258 (SD 35607) Conclusion: strong indication for cost-effectiveness |