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Depression interventions for individuals with coronary artery disease - Cost-effectiveness calculations from an Irish

Samira Barbara Jabakhanji1, Jan Sorensen1, Robert M Carney2

  • 1Healthcare Outcomes Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.

Journal of Psychosomatic Research
|February 6, 2022
PubMed

Insights

Group exercise is the most cost-effective depression treatment for coronary artery disease patients after 8 weeks. Pharmacotherapy becomes more cost-effective at 26 weeks, though exercise data is limited.

Area of Science:

  • Cardiovascular Medicine
  • Psychiatry
  • Health Economics

Background:

  • Coronary artery disease (CAD) patients frequently experience depression requiring intervention.
  • Assessing cost-effectiveness of depression treatments in CAD is crucial for resource allocation.

Purpose of the Study:

  • To evaluate the cost-effectiveness of four depression interventions in individuals with CAD.
  • To compare pharmacotherapy, psychotherapy, collaborative care, and exercise.

Main Methods:

  • Effectiveness data from a network meta-analysis for remission rates at 8 and 26 weeks.
  • Cost analysis included medication, contact frequency, and staff time.
  • Calculated incremental cost-effectiveness ratios (ICERs) compared to usual care.
  • Performed sensitivity analyses for various scenarios.

Main Results:

  • At 8 weeks, group exercise had the lowest ICER (€526/remission), followed by pharmacotherapy (€589).
  • At 26 weeks, pharmacotherapy (€591) was more cost-effective than collaborative care (€7203) and individual psychotherapy (€9387).
  • Sensitivity analysis suggested group psychotherapy could be highly cost-effective, but trial data was limited.

Conclusions:

  • Significant variation exists in the cost-effectiveness of depression interventions for CAD patients.
  • Group exercise emerged as the most cost-effective option at 8 weeks under current assumptions.
  • Pharmacotherapy demonstrated better cost-effectiveness at 26 weeks.
Abstract

Keywords:
Coronary artery diseaseCost-effectivenessDepressionExercise therapyIrelandPsychosocial intervention

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