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Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients

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  • Matthijs van den Berg
  • Filip Smit
  • Theo Vos
  • Pieter H M van Baal

Abstract

Background: Depression causes a large burden of disease worldwide. Effective prevention has the potential to reduce that burden considerably. This study aimed to investigate the cost-effectiveness of minimal contact psychotherapy, based on Lewinsohn's ‘Coping with depression’ course, targeted at opportunistically screened individuals with sub-threshold depression. Methods and Results: Using a Markov model, future health effects and costs of an intervention scenario and a current practice scenario were estimated. The time horizon was five years. Incremental cost-effectiveness ratios were expressed in euro per Disability Adjusted Life Year (DALY) averted. Probabilistic sensitivity analysis was employed to study the effect of uncertainty in the model parameters. From the health care perspective the incremental cost-effectiveness ratio was € 1,400 per DALY, and from the societal perspective the intervention was cost-saving. Although the estimated incremental costs and effects were surrounded with large uncertainty, given a willingness to pay of € 20,000 per DALY, the probability that the intervention is cost-effective was around 80%. Conclusion: This modelling study showed that opportunistic screening in primary care for sub-threshold depression in combination with minimal contact psychotherapy may be cost-effective in the prevention of major depression.

Suggested Citation

  • Matthijs van den Berg & Filip Smit & Theo Vos & Pieter H M van Baal, 2011. "Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients," PLOS ONE, Public Library of Science, vol. 6(8), pages 1-7, August.
    • Handle: RePEc:plo:pone00:0022884
    DOI: 10.1371/journal.pone.0022884
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    References listed on IDEAS

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    Cited by:

    1. Karolien E M Biesheuvel-Leliefeld & Judith E Bosmans & Sandra M A Dijkstra-Kersten & Filip Smit & Claudi L H Bockting & Digna J F van Schaik & Harm W J van Marwijk & Henriette E van der Horst, 2018. "A supported self-help for recurrent depression in primary care; An economic evaluation alongside a multi-center randomised controlled trial," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-18, December.
    2. Maria Rubio-Valera & Timothy F. Chen & Claire L. O'Reilly, 2014. "New Roles for Pharmacists in Community Mental Health Care: A Narrative Review," IJERPH, MDPI, vol. 11(10), pages 1-24, October.

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