Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial
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Petronella Van't Veer-Tazelaar1, Filip Smit, Hein van Hout
1Department of General Practice, Institute for Research in Extramural Medicine, VU Medical Centre, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. pj.vantveer@vumc.nl
Background:
There is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.
Aims:
To establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with routine primary care.
Method:
An economic evaluation was conducted alongside a pragmatic randomised controlled trial (ISRCTN26474556). Consenting individuals presenting with subthreshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme (n = 86) or to routine primary care (n = 84).
Results:
The intervention was successful in halving the incidence rate of depression and anxiety at euro563 ( pound412) per recipient and euro4367 ( pound3196) per disorder-free year gained, compared with routine primary care. The latter would represent good value for money if the willingness to pay for a disorder-free year is at least euro5000.
Conclusions:
The prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.
