Screening for and Treating Postpartum Depression and Psychosis: A Cost-Effectiveness Analysis

Area of Science:

• Reproductive Health
• Mental Health
• Health Economics

Background:

• Postpartum depression affects 6.5-12.9% of U.S. women.
• It is linked to adverse outcomes for mother and child, yet screening is not standard.
• Current care lacks proactive identification and treatment of postpartum mood disorders.

Purpose of the Study:

• To model the cost-effectiveness of physician-led screening and treatment for postpartum depression and psychosis.
• To evaluate this intervention in partnership with psychiatric services.
• To inform clinical practice and healthcare policy regarding maternal mental health.

Main Methods:

• A hypothetical cohort of 1000 pregnant women was modeled over 2 years.
• A decision tree model using the Edinburgh Postnatal Depression Scale was employed.
• Analysis adopted a Medicaid payer perspective, measuring cost per remission and QALY gained.

Main Results:

• The intervention resulted in 29 additional healthy women per 1000.
• The cost was $943 per woman, with an ICER of $13,857 per QALY gained.
• Results were robust across sensitivity analyses, indicating cost-effectiveness.

Conclusions:

• Screening for and treating postpartum depression and psychosis is a cost-effective intervention.
• This approach should be integrated into routine postnatal care.
• Findings support recent recommendations for universal screening by the U.S. Preventive Services Task Force.