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Article
Cost-utility analysis studies of depression management: a systematic review
Quantitative Health Sciences Publications and Presentations
  • Paul A. Pirraglia, Brown Medical School
  • Allison B. Rosen, University of Massachusetts Medical School
  • Richard C. Hermann, Harvard Medical School
  • Natalia V. Olchanski, Harvard School of Public Health
  • Peter J. Neumann, Harvard School of Public Health
UMMS Affiliation
Department of Quantitative Health Sciences
Date
12-1-2004
Document Type
Article
Medical Subject Headings
Adult; Aged; Antidepressive Agents; Cost-Benefit Analysis; Costs and Cost Analysis; Depressive Disorder; Disease Management; Drug Costs; Female; Health Services Research; Humans; Male; Middle Aged; Psychotherapy; *Quality of Life; *Quality-Adjusted Life Years
Abstract

OBJECTIVE: Depression is common, costly, treatable, and a major influence on quality of life. Cost-utility analysis combines costs with quantity and quality of life into a metric that is meaningful for studies of interventions or care strategies and is directly comparable to measures in other such studies. The objectives of this study were to identify published cost-utility analyses of depression screening, pharmacologic treatment, nonpharmacologic therapy, and care management; to summarize the results of these studies in an accessible format; to examine the analytic methods employed; and to identify areas in the depression literature that merit cost-utility analysis.

METHOD: The authors selected articles regarding cost-utility analysis of depression management from the Harvard Center for Risk Analysis Cost-Effectiveness Registry. Characteristics of the publications, including study methods and analysis, were examined. Cost-utility ratios for interventions were arranged in a league table.

RESULTS: Of the 539 cost-utility analyses in the registry, nine (1.7%) were of depression management. Methods for determining utilities and the source of the data varied. Markov models or cohort simulations were the most common analytic techniques. Pharmacologic interventions generally had lower costs per quality-adjusted life year than nonpharmacologic interventions. Psychotherapy alone, care management alone, and psychotherapy plus care management all had lower costs per quality-adjusted life year than usual care. Depression screening and treatment appeared to fall within the cost-utility ranges accepted for common nonpsychiatric medical conditions.

CONCLUSIONS: There is a paucity of literature on cost-utility analysis of depression management. High-quality cost-utility analysis should be considered for further research in depression management.

Rights and Permissions
Citation: Am J Psychiatry. 2004 Dec;161(12):2155-62. Link to article on publisher's site
Related Resources
Link to Article in PubMed
Citation Information
Paul A. Pirraglia, Allison B. Rosen, Richard C. Hermann, Natalia V. Olchanski, et al.. "Cost-utility analysis studies of depression management: a systematic review" Vol. 161 Iss. 12 (2004) ISSN: 0002-953X (Linking)
Available at: http://works.bepress.com/allison_rosen/40/