TY - JOUR
KW - Adolescent
KW - Adult
KW - Antidepressive Agents/therapeutic use
KW - Chile
KW - Chronic Disease
KW - Cohort Studies
KW - Cost-Benefit Analysis
KW - Decision Support Techniques
KW - Depressive Disorder, Major/economics/epidemiology/therapy
KW - Female
KW - Gross Domestic Product
KW - Health Care Costs/statistics & numerical data
KW - Humans
KW - Markov Chains
KW - Models, Theoretical
KW - Primary Health Care/economics/methods/utilization
KW - Program Evaluation
KW - Quality-Adjusted Life Years
KW - Recurrence
AU - D. Siskind
AU - R. Araya
AU - J. Kim
A1 - 
AB - BACKGROUND: Low- and middle-income countries lack information on contextualised mental health interventions to aid resource allocation decisions regarding healthcare. AIMS: To undertake a cost-effectiveness analysis of treatments for depression contextualised to Chile. METHODS: Using data from studies in Chile, we developed a computer-based Markov cohort model of depression among Chilean women to evaluate the cost-effectiveness of usual care or improved stepped care. RESULTS: The incremental cost-effectiveness ratio (ICER) of usual care was I$113 per quality-adjusted life-year (QALY) gained, versus no treatment, whereas stepped care had an ICER of I$468 per QALY versus usual care. This compared favourably with Chile's per-capita GDP. Results were most sensitive to variation in recurrent episode coverage, marginally sensitive to cost of treatment, and insensitive to changes in health-state utility of depression and rate of recurrence. CONCLUSIONS: Our results suggest that treatments for depression in low- and middle-income countries may be more cost-effective than previously estimated.
BT - The British journal of psychiatry : the journal of mental science
C5 - Financing & Sustainability
CP - 4
CY - England
DO - 10.1192/bjp.bp.109.068957
IS - 4
JF - The British journal of psychiatry : the journal of mental science
N2 - BACKGROUND: Low- and middle-income countries lack information on contextualised mental health interventions to aid resource allocation decisions regarding healthcare. AIMS: To undertake a cost-effectiveness analysis of treatments for depression contextualised to Chile. METHODS: Using data from studies in Chile, we developed a computer-based Markov cohort model of depression among Chilean women to evaluate the cost-effectiveness of usual care or improved stepped care. RESULTS: The incremental cost-effectiveness ratio (ICER) of usual care was I$113 per quality-adjusted life-year (QALY) gained, versus no treatment, whereas stepped care had an ICER of I$468 per QALY versus usual care. This compared favourably with Chile's per-capita GDP. Results were most sensitive to variation in recurrent episode coverage, marginally sensitive to cost of treatment, and insensitive to changes in health-state utility of depression and rate of recurrence. CONCLUSIONS: Our results suggest that treatments for depression in low- and middle-income countries may be more cost-effective than previously estimated.
PP - England
PY - 2010
SN - 1472-1465; 0007-1250
SP - 291
EP - 296
EP - 
T1 - Cost-effectiveness of improved primary care treatment of depression in women in Chile
T2 - The British journal of psychiatry : the journal of mental science
TI - Cost-effectiveness of improved primary care treatment of depression in women in Chile
U1 - Financing & Sustainability
U2 - 20884952
U3 - 10.1192/bjp.bp.109.068957
VL - 197
VO - 1472-1465; 0007-1250
Y1 - 2010
ER -