BMC Health Services Research (Jan 2010)

Cost-effectiveness of collaborative care for the treatment of major depressive disorder in primary care. A systematic review

  • van Marwijk Harm WJ,
  • Horn Eva K,
  • van der Feltz-Cornelis Christina M,
  • van Steenbergen-Weijenburg Kirsten M,
  • Beekman Aartjan TF,
  • Rutten Frans FH,
  • Hakkaart-van Roijen Leona

DOI
https://doi.org/10.1186/1472-6963-10-19
Journal volume & issue
Vol. 10, no. 1
p. 19

Abstract

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Abstract Background The effectiveness of collaborative care for patients with major depressive disorder in primary care has been established. Assessing its cost-effectiveness is important for deciding on implementation. This review therefore evaluates the cost-effectiveness of collaborative care for major depressive disorder in primary care. Methods A systematic search on economic evaluations of collaborative care was conducted in Pubmed and PsychInfo. Quality of the studies was measured with the Cochrane checklist and the CHEC-list for economic evaluations. Cost-effectiveness and costs per depression-free days were reported. Results 8 studies were found, involving 4868 patients. The quality of the cost effectiveness studies, according to the CHEC-list, could be improved. Generally, the studies did not include all relevant costs and did not perform sensitivity analysis. Only 4 out of 8 studies reported cost per QALY, 6 out of 8 reported costs per depression-free days. The highest costs per QALY reported were $49,500, the highest costs per depression-free day were $24. Conclusions Although studies did not fulfil all criteria of the CHEC-list, collaborative care is a promising intervention and it may be cost-effective. However, to conclude on the cost-effectiveness, depression research should follow economic guidelines to improve the quality of the economic evaluations.