Cost-effectiveness analysis for pharmacological intervention and cognitive behavioral treatment (CBT) for major depression in Thailand

Prukkanone, B., Vos, T., Bertram, M. and Burgess, P. (2010). Cost-effectiveness analysis for pharmacological intervention and cognitive behavioral treatment (CBT) for major depression in Thailand. In: ISPOR 4th Asia-Pacific Conference Research Abstracts. ISPOR 4th Asia-Pacific Conference, Phuket, Thailand, (A555-A555). 5-7 September 2010. doi:10.1111/j.1524-4733.2010.00793_3.x


Author Prukkanone, B.
Vos, T.
Bertram, M.
Burgess, P.
Title of paper Cost-effectiveness analysis for pharmacological intervention and cognitive behavioral treatment (CBT) for major depression in Thailand
Conference name ISPOR 4th Asia-Pacific Conference
Conference location Phuket, Thailand
Conference dates 5-7 September 2010
Proceedings title ISPOR 4th Asia-Pacific Conference Research Abstracts   Check publisher's open access policy
Journal name Value in Health   Check publisher's open access policy
Place of Publication Hoboken, NJ, U.S.A.
Publisher Wiley-Blackwell Publishing
Publication Year 2010
Sub-type Poster
DOI 10.1111/j.1524-4733.2010.00793_3.x
ISSN 1098-3015
1524-4733
Volume 13
Issue 7
Start page A555
End page A555
Total pages 1
Language eng
Formatted Abstract/Summary
Objectives: To determine the cost-effectiveness of interventions for major depression in Thailand.

Methods:
A microsimulation model was developed to describe the course of disease in individuals. Model inputs included Thai data on disease parameters and costs while impact measures are derived from a systematic review and meta-analysis of the international literature. Results are presented as cost (Thai Baht) per disability adjusted life-year (DALY) averted, compared to the null scenario (do nothing). Fluoxetine as the cheapest antidepressant drug in Thailand was analyzed for treatment of episodes plus a 6 month continuation phase and for maintenance treatment over 5 years of follow-up. Cognitive behavioral therapy (CBT) was analyzed for episodic treatment and for 5-year maintenance treatment.

Results:
The incremental cost-effectiveness ratios (ICER) of fl uoxetine for episodic treatment with or without a continuation or maintenance phase are just below one times GDP per capita in Thailand of 110,000 Baht. CBT during an episode of depression (ICER = 39,000) is more cost effective than medications (ICER = 88,000); a maintenance version of CBT is the most cost-effective option with an ICER of 27,000. Episodic drug treatment has the lowest cost (250 Million Baht) and averts 3000 DALYs. Episodic treatment with CBT, which has an ongoing effect for 1.5 years, costs 100 Million Baht more than drug treatment but it averts more than 6000 DALYs compared to drugs.

Conclusions:
CBT is the most cost-effective treatment option for both episodic and maintenance treatment. Maintenance treatment is the more cost-effective of the two. However, there is currently a lack of mental health personal, especially psychiatrists and psychologists, who would be expected to deliver CBT in Thailand. Antidepressant drugs are quite a bit less effective but also less costly than CBT.

Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Poster no.PMH11

Document type: Conference Paper
Collection: School of Public Health Publications
 
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Created: Sun, 09 Jan 2011, 00:00:33 EST