Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET)

Autor: Michael Barkham, Glyn Lewis, Linda Gask, David Kessler, Colin Green, David Richards, Ricardo Araya, Adwoa Hughes-Morley, Stephen Pilling, Peter Bower, Carolyn Chew-Graham, Martin Bland, Simon Gilbody, Karina Lovell, John Cape, Chris Manning, Jacqueline J Hill
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Adult
Male
medicine.medical_specialty
Economics
Cost effectiveness
Cost-Benefit Analysis
Cost-Effectiveness Analysis
Social Sciences
Collaborative Care
lcsh:Medicine
03 medical and health sciences
0302 clinical medicine
Quality of life (healthcare)
Nursing
Mental Health and Psychiatry
Health care
Medicine and Health Sciences
Humans
Medicine
030212 general & internal medicine
Cluster randomised controlled trial
Cooperative Behavior
lcsh:Science
Primary Care
health care economics and organizations
Health Care Policy
Multidisciplinary
Primary Health Care
Mood Disorders
Depression
business.industry
030503 health policy & services
lcsh:R
Cost-effectiveness analysis
Economic Analysis
United Kingdom
3. Good health
Quality-adjusted life year
Health Care
Treatment Outcome
Family medicine
Economic evaluation
Quality of Life
Female
lcsh:Q
Quality-Adjusted Life Years
0305 other medical science
business
Research Article
Zdroj: PLoS ONE, Vol 9, Iss 8, p e104225 (2014)
Green, C, Richards, D A, Hill, J J, Gask, L, Lovell, K, Chew-Graham, C, Bower, P, Cape, J, Pilling, S, Araya, R, Kessler, D, Bland, J M, Gilbody, S, Lewis, G, Manning, C, Hughes-Morley, A & Barkham, M 2014, ' Cost-effectiveness of collaborative care for depression in UK primary care: Economic evaluation of a randomised controlled trial (CADET) ', PLoS ONE, vol. 9, no. 8, e104225 . https://doi.org/10.1371/journal.pone.0104225
PLoS ONE
ISSN: 1932-6203
Popis: Background: Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking.\ud \ud Aims: To assess the cost-effectiveness of collaborative care in a UK primary care setting.\ud \ud Methods: An economic evaluation alongside a multi-centre cluster randomised controlled trial comparing collaborative care with usual primary care for adults with depression (n = 581). Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) were calculated over a 12-month follow-up, from the perspective of the UK National Health Service and Personal Social Services (i.e. Third Party Payer). Sensitivity analyses are reported, and uncertainty is presented using the cost-effectiveness acceptability curve (CEAC) and the cost-effectiveness plane.\ud \ud Results: The collaborative care intervention had a mean cost of £272.50 per participant. Health and social care service use, excluding collaborative care, indicated a similar profile of resource use between collaborative care and usual care participants. Collaborative care offered a mean incremental gain of 0.02 (95% CI: –0.02, 0.06) quality-adjusted life-years over 12 months, at a mean incremental cost of £270.72 (95% CI: –202.98, 886.04), and resulted in an estimated mean cost per QALY of £14,248. Where costs associated with informal care are considered in sensitivity analyses collaborative care is expected to be less costly and more effective, thereby dominating treatment as usual.\ud \ud Conclusion: Collaborative care offers health gains at a relatively low cost, and is cost-effective compared with usual care against a decision-maker willingness to pay threshold of £20,000 per QALY gained. Results here support the commissioning of collaborative care in a UK primary care setting.
Databáze: OpenAIRE