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    Cost-utility analysis studies of depression management: a systematic review

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    Authors
    Pirraglia, Paul A.
    Rosen, Allison B.
    Hermann, Richard C.
    Olchanski, Natalia V.
    Neumann, Peter J.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2004-12-01
    Keywords
    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
    Biostatistics
    Epidemiology
    Health Services Research
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    Link to Full Text
    http://dx.doi.org/10.1176/appi.ajp.161.12.2155
    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.
    Source
    Am J Psychiatry. 2004 Dec;161(12):2155-62. Link to article on publisher's site
    DOI
    10.1176/appi.ajp.161.12.2155
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47775
    PubMed ID
    15569883
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1176/appi.ajp.161.12.2155
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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