Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression.
OBJECTIVE: Antidepressant drugs and cognitive-behavioural therapy (CBT) are effective treatment options for depression and are recommended by clinical practice guidelines. As part of the Assessing Cost-effectiveness -- Mental Health project we evaluate the available evidence on costs and benefits of...
| Published in: | Australian & New Zealand Journal of Psychiatry Vol. 39; no. 8; pp. 683 - 693 |
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| Main Authors: | , , , , |
| Format: | research Journal Article |
| Published: |
Sage Publications Inc.
Aug2005
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106552094&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106552094 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Aug2005 vid: 39 iid: 8 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 106552094 106552094 2009065619 10.1080/j.1440-1614.2005.01652.x NLM16050922 106552094 ppf: 683 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression. aug: au: Vos T Corry J Haby MM Carter R Andrews G affil: School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006, Australia; t.vos@sph.uq.edu.au sug: subj: Antidepressive Agents Therapeutic Use Cognitive Therapy Depression Economics Australia Cost Benefit Analysis Descriptive Statistics Human ab: OBJECTIVE: Antidepressant drugs and cognitive-behavioural therapy (CBT) are effective treatment options for depression and are recommended by clinical practice guidelines. As part of the Assessing Cost-effectiveness -- Mental Health project we evaluate the available evidence on costs and benefits of CBT and drugs in the episodic and maintenance treatment of major depression. METHOD: The cost-effectiveness is modelled from a health-care perspective as the cost per disability-adjusted life year. Interventions are targeted at people with major depression who currently seek care but receive non-evidence based treatment. Uncertainty in model inputs is tested using Monte Carlo simulation methods. RESULTS: All interventions for major depression examined have a favourable incremental cost-effectiveness ratio under Australian health service conditions. Bibliotherapy, group CBT, individual CBT by a psychologist on a public salary and tricyclic antidepressants (TCAs) are very cost-effective treatment options falling below 10,000 Australian dollars per disability-adjusted life year (DALY) even when taking the upper limit of the uncertainty interval into account. Maintenance treatment with selective serotonin re-uptake inhibitors (SSRIs) is the most expensive option (ranging from 17,000 Australian dollars to 20,000 Australian dollars per DALY) but still well below 50,000 Australian dollars, which is considered the affordable threshold. CONCLUSIONS: A range of cost-effective interventions for episodes of major depression exists and is currently underutilized. Maintenance treatment strategies are required to significantly reduce the burden of depression, but the cost of long-term drug treatment for the large number of depressed people is high if SSRIs are the drug of choice. Key policy issues with regard to expanded provision of CBT concern the availability of suitably trained providers and the funding mechanisms for therapy in primary care. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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