Cost-effectiveness analysis of a collaborative care programme for depression in primary care

Area of Science:

• Health Economics
• Mental Health Services Research
• Clinical Trial Analysis

Background:

• Collaborative care programs are effective for managing depression.
• A specific collaborative care program has shown effectiveness in Spanish primary care settings.
• The study aimed to assess the economic viability of this program compared to standard care.

Purpose of the Study:

• To evaluate the cost-effectiveness of a collaborative care program for depression.
• To compare the program's costs and outcomes against usual care.
• To determine the incremental cost-effectiveness ratios (ICERs) from both healthcare and societal perspectives.

Main Methods:

• A bottom-up cost-effectiveness analysis was performed within a randomized controlled trial (2007-2010).
• The intervention involved a collaborative care program with integrated clinical, educational, and organizational components.
• Primary outcomes included ICERs calculated using quality-adjusted life years (QALY) and depression-free days (DFD) over a 12-month period.

Main Results:

• The collaborative care program resulted in an average incremental cost of €182.53 per patient from a healthcare perspective.
• The program demonstrated incremental effectiveness of 0.045 QALY and 40.09 DFD.
• The calculated ICERs were €4,056 per QALY and €4.55 per DFD, indicating favorable cost-effectiveness.

Conclusions:

• The collaborative care intervention offers improved patient outcomes compared to usual care at a minimal additional cost.
• Favorable ICERs support the recommendation for implementing this collaborative care model in primary care.
• Potential bias from incomplete patient data and limited non-healthcare cost data were noted limitations.