TY - JOUR
KW - Cost-Benefit Analysis
KW - Depressive Disorder/economics/therapy
KW - Health Care Costs
KW - Humans
KW - Primary Health Care/economics
KW - Program Evaluation
KW - Randomized Controlled Trials as Topic
AU - S. Gilbody
AU - P. Bower
AU - P. Whitty
A1 - 
AB - BACKGROUND: A number of enhancement strategies have been proposed to improve the quality and outcome of care for depression in primary care settings. Decision-makers are likely to need to know whether these interventions are cost-effective in routine primary care settings. METHOD: We conducted a systematic review of all full economic evaluations (cost-effectiveness and cost-utility analyses) accompanying randomised controlled trials of enhanced primary care for depression. Costs were standardised to UK pounds/US dollars and incremental cost-effectiveness ratios (ICERs) were visually summarised using a permutation matrix. RESULTS: We identified 11 full economic evaluations (4757 patients). A near-uniform finding was that the interventions based upon collaborative care/case management resulted in improved outcomes but were also associated with greater costs. When considering primary care depression treatment costs alone, ICER estimates ranged from 7 ($13, no confidence interval given) to 13 UK pounds ($24,95% CI -105 to 148) per additional depression-free day. Educational interventions alone were associated with increased cost and no clinical benefit. CONCLUSIONS: Improved outcomes through depression management programmes using a collaborative care/case management approach can be expected, but are associated with increased cost and will require investment.
BT - The British journal of psychiatry : the journal of mental science
C5 - Financing & Sustainability
CY - England
DO - 10.1192/bjp.bp.105.016006
JF - The British journal of psychiatry : the journal of mental science
N2 - BACKGROUND: A number of enhancement strategies have been proposed to improve the quality and outcome of care for depression in primary care settings. Decision-makers are likely to need to know whether these interventions are cost-effective in routine primary care settings. METHOD: We conducted a systematic review of all full economic evaluations (cost-effectiveness and cost-utility analyses) accompanying randomised controlled trials of enhanced primary care for depression. Costs were standardised to UK pounds/US dollars and incremental cost-effectiveness ratios (ICERs) were visually summarised using a permutation matrix. RESULTS: We identified 11 full economic evaluations (4757 patients). A near-uniform finding was that the interventions based upon collaborative care/case management resulted in improved outcomes but were also associated with greater costs. When considering primary care depression treatment costs alone, ICER estimates ranged from 7 ($13, no confidence interval given) to 13 UK pounds ($24,95% CI -105 to 148) per additional depression-free day. Educational interventions alone were associated with increased cost and no clinical benefit. CONCLUSIONS: Improved outcomes through depression management programmes using a collaborative care/case management approach can be expected, but are associated with increased cost and will require investment.
PP - England
PY - 2006
SN - 0007-1250; 0007-1250
SP - 297
EP - 308
EP - 
T1 - Costs and consequences of enhanced primary care for depression: Systematic review of randomised economic evaluations
T2 - The British journal of psychiatry : the journal of mental science
TI - Costs and consequences of enhanced primary care for depression: Systematic review of randomised economic evaluations
U1 - Financing & Sustainability
U2 - 17012652
U3 - 10.1192/bjp.bp.105.016006
VL - 189
VO - 0007-1250; 0007-1250
Y1 - 2006
ER -