Cost-effectiveness of integrated collaborative care for comorbid major depression in patients with cancer.

Abstract

OBJECTIVES:

Comorbid major depression is associated with reduced quality of life and greater use of healthcare resources. A recent randomised trial (SMaRT, Symptom Management Research Trials, Oncology-2) found that a collaborative care treatment programme (Depression Care for People with Cancer, DCPC) was highly effective in treating depression in patients with cancer. This study aims to estimate the cost-effectiveness of DCPC compared with usual care from a health service perspective.

METHODS:

Costs were estimated using UK national unit cost estimates and health outcomes measured using quality-adjusted life-years (QALYs). Incremental cost-effectiveness of DCPC compared with usual care was calculated and scenario analyses performed to test alternative assumptions on costs and missing data. Uncertainty was characterised using cost-effectiveness acceptability curves. The probability of DCPC being cost-effective was determined using the UK National Institute for Health and Care Excellence's (NICE) cost-effectiveness threshold range of £ 20,000 to £ 30,000 per QALY gained.

RESULTS:

DCPC cost on average £ 631 more than usual care per patient, and resulted in a mean gain of 0.066 QALYs, yielding an incremental cost-effectiveness ratio of £ 9549 per QALY. The probability of DCPC being cost-effective was 0.9 or greater at cost-effectiveness thresholds above £ 20,000 per QALY for the base case and scenario analyses.

CONCLUSIONS:

Compared with usual care, DCPC is likely to be cost-effective at the current thresholds used by NICE. This study adds to the weight of evidence that collaborative care treatment models are cost-effective for depression, and provides new evidence regarding their use in specialist medical settings.

• Authors: A Duarte, J Walker, S Walker, G Richardson, C Holm Hansen, P Martin, G Murray, M Sculpher, M Sharpe
• Journal: Journal of psychosomatic research (J Psychosom Res) Vol. 79 Issue 6 Pg. 465-70 (Dec 2015) ISSN: 1879-1360 [Electronic] England
• PMID: 26652589 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Comorbidity
• Cost-Benefit Analysis
• Delivery of Health Care, Integrated (economics)
• Depression (economics, therapy)
• Depressive Disorder, Major (economics, therapy)
• Female
• Humans
• Male
• Middle Aged
• Neoplasms (psychology)
• Patient Care Team
• Quality of Life
• Quality-Adjusted Life Years