gms | German Medical Science

14. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

7. - 9. Oktober 2015, Berlin

Cost-effectiveness of collaborative care for the treatment of depressive disorders in primary care: A systematic review

Meeting Abstract

  • Thomas Grochtdreis - Universitätsklinikum Hamburg-Eppendorf , Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg, Deutschland
  • Christian Brettschneider - Universitätsklinikum Hamburg-Eppendorf , Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg, Deutschland
  • Annemarie Wegener - Universitätsklinikum Hamburg-Eppendorf , Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg, Deutschland
  • Hans-Helmut König - Universitätsklinikum Hamburg-Eppendorf , Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg, Deutschland
  • Martin Härter - Universitätsklinikum Hamburg-Eppendorf, Institut und Poliklinik für Medizinische Psychologie, Zentrum für Psychosoziale Medizin, Hamburg, Deutschland
  • Birgit Watzke - Universität Zürich, Psychologisches Institut, Zürich, Schweiz
  • Steffi G. Riedel-Heller - Universität Leipzig, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland

14. Deutscher Kongress für Versorgungsforschung. Berlin, 07.-09.10.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocV68

doi: 10.3205/15dkvf077, urn:nbn:de:0183-15dkvf0771

Published: September 22, 2015

© 2015 Grochtdreis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: For the treatment of depressive disorders, the framework of collaborative care has been recommended which showed improved outcomes in the primary care sector. Yet, an earlier literature review did not find sufficient evidence to draw robust conclusions on the cost-effectiveness of collaborative care.

Purpose: To systematically review studies on the cost-effectiveness of collaborative care compared with usual care for the treatment of patients with depressive disorders in primary care.

Methods: A systematic literature search in major databases was conducted. Risk of bias was assessed using the Cochrane Collaboration’s tool. Methodological quality of the articles was assessed using the Consensus on Health Economic Criteria (CHEC) list. To ensure comparability across studies, cost data were inflated to the year 2012 using country-specific gross domestic product inflation rates, and were adjusted to international dollars using purchasing power parities (PPP).

Results: In total, 19 cost-effectiveness analyses were reviewed. The included studies had sample sizes between n=65 to n=1,801 and time horizons between six to 24 months. Between 42% and 89% of the CHEC quality criteria were fulfilled, and in only one study no risk of bias was identified. A societal perspective was used by five studies. Incremental costs per depression-free day ranged from dominance to US$PPP 64.89 and incremental costs per QALY from dominance to US$PPP 874,562.

Conclusion: Despite our review improved the comparability of study results, cost-effectiveness of collaborative care compared with usual care for the treatment of patients with depressive disorders in primary care is ambiguous depending on willingness to pay. A still considerable uncertainty due to inconsistent methodological quality and results among included studies suggests further cost-effectiveness analyses using QALYs as effect measures and a time horizon of at least 1 year.