TY - JOUR
KW - Cognitive Therapy/economics
KW - Confidence Intervals
KW - Cost-Benefit Analysis
KW - Depression, Postpartum/economics/therapy
KW - Expert Testimony
KW - Female
KW - Great Britain
KW - Health Status Indicators
KW - Humans
KW - Models, Theoretical
KW - Pregnancy
KW - Primary Health Care/economics
KW - Probability
KW - Psychometrics
KW - Psychotherapy, Group/economics
KW - Quality-Adjusted Life Years
AU - M. D. Stevenson
AU - A. Scope
AU - P. A. Sutcliffe
A1 - 
AB - OBJECTIVE: To assess the cost-effectiveness of group cognitive behavior therapy (gCBT) in comparison with routine primary care for women with postnatal depression in the UK. METHODS: Our analysis was based on a systematic literature review of the relative clinical effectiveness of gCBT compared with routine primary care and further reviews, supplemented with expert opinion of the likely cost of providing gCBT and the duration of comparative advantage for gCBT. Raw data were used to estimate a statistical relationship between changes in the Edinburgh Postnatal Depression Score (EPDS) values and changes in short-form six dimensions' (SF-6D) values. A mathematical model was constructed, and probabilistic sensitivity analyses were undertaken to estimate the mean cost per quality-adjusted life-year (QALY) and to evaluate the expected value of perfect information (EVPI). RESULTS: The mean cost per QALY from the stochastic analysis was estimated to be pound36,062; however, there was considerable uncertainty around this value. The EVPI was estimated to be greater than pound64 million; the key uncertainties were in the cost per woman of providing treatment and in the statistical relationship between changes in EPDS values and changes in SF-6D values. The expected value of perfect partial information for both of these parameters was in excess of pound25 million. CONCLUSIONS: Given the current information, the use of gCBT does not appear to be cost-effective; however, this decision is uncertain. The value of information analyses conducted indicates that further research to provide robust information on key parameters is needed and appears justified in cost-effective terms.
BT - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
C5 - Financing & Sustainability
CP - 5
CY - United States
DO - 10.1111/j.1524-4733.2010.00720.x
IS - 5
JF - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
N2 - OBJECTIVE: To assess the cost-effectiveness of group cognitive behavior therapy (gCBT) in comparison with routine primary care for women with postnatal depression in the UK. METHODS: Our analysis was based on a systematic literature review of the relative clinical effectiveness of gCBT compared with routine primary care and further reviews, supplemented with expert opinion of the likely cost of providing gCBT and the duration of comparative advantage for gCBT. Raw data were used to estimate a statistical relationship between changes in the Edinburgh Postnatal Depression Score (EPDS) values and changes in short-form six dimensions' (SF-6D) values. A mathematical model was constructed, and probabilistic sensitivity analyses were undertaken to estimate the mean cost per quality-adjusted life-year (QALY) and to evaluate the expected value of perfect information (EVPI). RESULTS: The mean cost per QALY from the stochastic analysis was estimated to be pound36,062; however, there was considerable uncertainty around this value. The EVPI was estimated to be greater than pound64 million; the key uncertainties were in the cost per woman of providing treatment and in the statistical relationship between changes in EPDS values and changes in SF-6D values. The expected value of perfect partial information for both of these parameters was in excess of pound25 million. CONCLUSIONS: Given the current information, the use of gCBT does not appear to be cost-effective; however, this decision is uncertain. The value of information analyses conducted indicates that further research to provide robust information on key parameters is needed and appears justified in cost-effective terms.
PP - United States
PY - 2010
SN - 1524-4733; 1098-3015
SP - 580
EP - 584
EP - 
T1 - The cost-effectiveness of group cognitive behavioral therapy compared with routine primary care for women with postnatal depression in the UK
T2 - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
TI - The cost-effectiveness of group cognitive behavioral therapy compared with routine primary care for women with postnatal depression in the UK
U1 - Financing & Sustainability
U2 - 20384978
U3 - 10.1111/j.1524-4733.2010.00720.x
VL - 13
VO - 1524-4733; 1098-3015
Y1 - 2010
ER -