Cost-effectiveness of a collaborative care program for primary care patients with persistent depression

Area of Science:

• Health Services Research
• Psychiatry
• Public Health

Background:

• Persistent depressive symptoms often require enhanced management beyond usual primary care.
• Effective treatment strategies for depression in primary care settings are crucial for improving patient outcomes.
• Collaborative care models show promise in managing chronic conditions.

Purpose of the Study:

• To evaluate the incremental cost-effectiveness of a stepped collaborative care model for patients with persistent depressive symptoms.
• To compare outcomes and costs of collaborative care versus usual care in primary care patients.
• To determine the economic value of enhanced depression management in primary care.

Main Methods:

• A randomized controlled trial involving primary care patients with persistent depressive symptoms.
• Patients were assigned to either usual care or a stepped collaborative care program.
• Clinical outcomes (depression-free days) and healthcare costs were assessed over six months.

Main Results:

• Collaborative care resulted in an average of 16.7 additional depression-free days over six months.
• The incremental cost of the collaborative care program was $357 per patient.
• The incremental cost-effectiveness was $21.44 per depression-free day.

Conclusions:

• Stepped collaborative care significantly improves depression treatment effectiveness in primary care.
• While associated with moderate cost increases, the return on investment is comparable to other accepted medical interventions.
• Investing additional resources in collaborative care models is justified by improved patient outcomes.