A Canadian Simulation Model for Major Depressive Disorder: Study Protocol.

Area of Science:

• Health economics
• Pharmacogenomics
• Computational modeling

Background:

• Major depressive disorder (MDD) is a prevalent condition with high healthcare costs.
• Current treatments often require multiple medication trials, impacting patient quality of life.
• There is a need for improved interventions to enhance remission rates and reduce economic burden.

Purpose of the Study:

• To develop an economic simulation model (SiMMDep) for assessing pharmacogenomic (PGx) testing in MDD treatment.
• To simulate the patient care pathway for individuals with MDD.
• To evaluate the effectiveness and cost-effectiveness of PGx testing.

Main Methods:

• Developed a discrete-time microsimulation model (SiMMDep) of MDD clinical pathways in British Columbia.
• Incorporated publicly-funded treatments, multiple treatment steps, and patient data.
• Utilized modular coding for flexibility, populated with administrative data, systematic reviews, and expert input.
• Validated the model through face, internal, and cross-validity checks.

Main Results:

• SiMMDep predicts health outcomes and costs from a health system perspective.
• The model can simulate PGx-guided treatment versus standard care.
• It estimates effectiveness, cost-effectiveness, resource utilization, and health gains of PGx testing.

Conclusions:

• SiMMDep is Canada's first medication-specific simulation model for MDD treatment, developed with patient input.
• It synthesizes data to predict the benefits and costs of PGx testing.
• The model's flexible infrastructure can support policy questions and efficiency improvements in depression care.