TY - JOUR
AU - C. Green
AU - D. A. Richards
AU - J. J. Hill
AU - L. Gask
AU - K. Lovell
AU - C. Chew-Graham
AU - P. Bower
AU - J. Cape
AU - S. Pilling
AU - R. Araya
AU - D. Kessler
AU - J. M. Bland
AU - S. Gilbody
AU - G. Lewis
AU - C. Manning
AU - A. Hughes-Morley
AU - M. Barkham
A1 - 
AB - BACKGROUND: Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking. AIMS: To assess the cost-effectiveness of collaborative care in a UK primary care setting. METHODS: An economic evaluation alongside a multi-centre cluster randomised controlled trial comparing collaborative care with usual primary care for adults with depression (n = 581). Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) were calculated over a 12-month follow-up, from the perspective of the UK National Health Service and Personal Social Services (i.e. Third Party Payer). Sensitivity analyses are reported, and uncertainty is presented using the cost-effectiveness acceptability curve (CEAC) and the cost-effectiveness plane. RESULTS: The collaborative care intervention had a mean cost of pound272.50 per participant. Health and social care service use, excluding collaborative care, indicated a similar profile of resource use between collaborative care and usual care participants. Collaborative care offered a mean incremental gain of 0.02 (95% CI: -0.02, 0.06) quality-adjusted life-years over 12 months, at a mean incremental cost of pound270.72 (95% CI: -202.98, 886.04), and resulted in an estimated mean cost per QALY of pound14,248. Where costs associated with informal care are considered in sensitivity analyses collaborative care is expected to be less costly and more effective, thereby dominating treatment as usual. CONCLUSION: Collaborative care offers health gains at a relatively low cost, and is cost-effective compared with usual care against a decision-maker willingness to pay threshold of pound20,000 per QALY gained. Results here support the commissioning of collaborative care in a UK primary care setting.
BT - PloS one
C5 - Financing & Sustainability
CP - 8
CY - United States
DO - 10.1371/journal.pone.0104225
IS - 8
JF - PloS one
N2 - BACKGROUND: Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking. AIMS: To assess the cost-effectiveness of collaborative care in a UK primary care setting. METHODS: An economic evaluation alongside a multi-centre cluster randomised controlled trial comparing collaborative care with usual primary care for adults with depression (n = 581). Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) were calculated over a 12-month follow-up, from the perspective of the UK National Health Service and Personal Social Services (i.e. Third Party Payer). Sensitivity analyses are reported, and uncertainty is presented using the cost-effectiveness acceptability curve (CEAC) and the cost-effectiveness plane. RESULTS: The collaborative care intervention had a mean cost of pound272.50 per participant. Health and social care service use, excluding collaborative care, indicated a similar profile of resource use between collaborative care and usual care participants. Collaborative care offered a mean incremental gain of 0.02 (95% CI: -0.02, 0.06) quality-adjusted life-years over 12 months, at a mean incremental cost of pound270.72 (95% CI: -202.98, 886.04), and resulted in an estimated mean cost per QALY of pound14,248. Where costs associated with informal care are considered in sensitivity analyses collaborative care is expected to be less costly and more effective, thereby dominating treatment as usual. CONCLUSION: Collaborative care offers health gains at a relatively low cost, and is cost-effective compared with usual care against a decision-maker willingness to pay threshold of pound20,000 per QALY gained. Results here support the commissioning of collaborative care in a UK primary care setting.
PP - United States
PY - 2014
SN - 1932-6203; 1932-6203
T1 - Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET)
T2 - PloS one
TI - Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET)
U1 - Financing & Sustainability
U2 - 25121991
U3 - 10.1371/journal.pone.0104225
VL - 9
VO - 1932-6203; 1932-6203
Y1 - 2014
ER -