Treatment for Moderate and Severe Depression: Decision Analysis for a Clinical Guideline
2006
This article, published in the British Journal of Psychiatry, presents a decision tree model that compares the cost-effectiveness of different treatment options for patients with moderate to severe depression in secondary care in the UK (i.e., antidepressants, psychological therapy and a combination of the two). Clinical, utility, and cost data were obtained from the published literature.
Over the 15-month analysis period, results indicate that combination therapy result in higher costs and an expected 0.16 increase per person in the probability of remission and no relapse compared with antidepressants. The cost per additional successfully treated patient is £4,056 (95% CI: £1,400-18,300); the cost per quality-adjusted life year gained is £5,777 (95% CI £1,900-33,800) for severe depression and £14,540 (95% CI £4,800-79,400) for moderate depression.
Based on these findings the authors conclude that combination therapy is likely to be a cost-effective first-line treatment for severe depression in secondary care in the UK. In patients with moderate depression these findings are less pronounced. The authors recommend targeted combination therapy.
Treatment for Moderate and Severe Depression: Decision Analysis for a Clinical Guideline
Source:
Simon J, Pilling S, Burbeck R et al. Treatment Options in Moderate and Severe Depression: Decision Analysis Supporting a Clinical Guideline. British Journal of Psychiatry 2006; 189 (6): 494-501. http://doi.org/10.1192/bjp.bp.105.014571