A personalized intervention to prevent depression in primary care: cost-effectiveness study nested into a clustered...

Area of Science:

• Public Health
• Preventive Medicine
• Health Economics

Background:

• Depression is a growing public health concern causing significant distress and societal costs.
• Preventing depression is a key strategy to mitigate its impact.
• Assessing individual risk for depression is crucial for targeted prevention efforts.

Purpose of the Study:

• To evaluate the cost-effectiveness of a personalized depression prevention intervention delivered in primary care.
• To compare this intervention against usual care for depression prevention.

Main Methods:

• A multicentre, clustered randomized controlled trial involving 140 general practitioners (GPs) and 3326 participants across Spain.
• Intervention included GPs communicating individual depression risk, co-creating tailored psychosocial programs, and patient empowerment strategies.
• Cost-effectiveness analysis from societal and National Health care perspectives over 18 months, using Quality-Adjusted Life Years (QALYs).

Main Results:

• The personalized intervention demonstrated a high probability of cost-effectiveness.
• With a willingness-to-pay threshold of €10,000, cost-effectiveness probabilities were 83% (societal) and 89% (health perspective).
• At a €30,000 threshold, probabilities increased to 94% (societal) and 96% (health perspective), confirmed by sensitivity analysis.

Conclusions:

• Personalized, risk-based depression prevention interventions implemented by GPs in primary care are cost-effective.
• This strategy offers a valuable approach to reduce the societal burden of depression.
• Further development and evaluation of such personalized primary care interventions are recommended.