Cost-Effectiveness of Antidepressants and CBT for Major Depression in Thailand
2012
This article, published in Value in Health, describes the adaptation of an earlier published discrete event simulation model to compare the cost-effectiveness of fluoxetine and cognitive-behavioral therapy (CBT) to a “do-nothing” scenario for major depression in Thailand. Fluoxetine and CBT are analyzed for episodic treatment and for 5-year maintenance treatment. Model inputs are derived from Thai data on disease parameters, while costs and impact parameters are obtained from a systematic review and meta-analysis of the international literature.
Five-year cost-effectiveness results show that CBT and generic fluoxetine can both be considered cost-effective treatment options for major depression in Thailand (i.e., the cost-effectiveness ratios were below the GDP of 110,000 bahts per capita). The uncertainty ranges around the cost-effectiveness ratios overlap: maintenance treatment with CBT 11,000 bahts per DALY averted (8,000-14,000); episodic treatment with CBT 23,000 bahts per DALY averted (10,000-36,000); episodic plus continuation drug treatment 33,000 bahts per DALY averted (26,000-44,000); maintenance drug treatment 38,000 bahts per DALY averted (30,000-48,000); and episodic drug treatment 42,000 bahts per DALY averted (32,000-57,000).
Cost-Effectiveness of Antidepressants and CBT for Major Depression in Thailand
Source:
Prukkanone B, Vos T, Bertram M et al. Cost-Effectiveness Analysis for Antidepressants and Cognitive Behavioral Therapy for Major Depression in Thailand. Value in Health 2012; 15 (1): S3-S8. http://doi.org/10.1016/j.jval.2011.11.009