Do indicated preventive interventions for depression represent good value for money?

Mihalopoulos, Catherine, Vos, Theo, Pirkis, Jane, Smit, Filip and Carter, Rob (2011) Do indicated preventive interventions for depression represent good value for money?. Australian And New Zealand Journal of Psychiatry, 45 1: 36-44. doi:10.3109/00048674.2010.501024

Author Mihalopoulos, Catherine
Vos, Theo
Pirkis, Jane
Smit, Filip
Carter, Rob
Title Do indicated preventive interventions for depression represent good value for money?
Journal name Australian And New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
Publication date 2011-01
Sub-type Article (original research)
DOI 10.3109/00048674.2010.501024
Volume 45
Issue 1
Start page 36
End page 44
Total pages 9
Place of publication Melbourne VIC, Australia
Publisher Informa Healthcare
Collection year 2012
Language eng
Formatted abstract
Objective: The prevention of depression is of growing interest to researchers and policy makers. However, the question of whether interventions designed to prevent depression provide value for money at a population level remains largely unanswered. The current study assesses the cost-effectiveness of two indicated interventions designed to prevent depression: a brief psychological intervention based on bibliotherapy and a more comprehensive group-based psychological intervention following opportunistic screening for sub-syndromal depression in general practice.

Method: Economic modelling using a cost utility framework was used to assess the incremental cost effectiveness ratios (ICERs) of the two interventions within the Australian population context, modelled as add-ons to current practice. The perspective was the health sector and outcomes were measured using disability-adjusted life years (DALYs). Uncertainty was measured using probabilistic uncertainty testing and important model assumptions were tested using univariate sensitivity testing.

Results: The brief bibliotherapy intervention had an ICER of AU$8600 per DALY and the group-based psychological intervention had an ICER of AU$20 000 per DALY. The majority of the uncertainty simulations for both interventions fell below the cost-effectiveness threshold value of $50 000 per DALY. Extensive sensitivity testing showed that the results were robust to the assumptions made in the analyses.

Following screening in general practice, both psychological interventions, particularly brief bibliotherapy, appear to be good value for money and worthy of further evaluation under routine care circumstances. Acceptability issues associated with such interventions, particularly to primary care practitioners as providers of the interventions and health system administrators, also need to be considered before wide-scale adoption is contemplated. 
Keyword Cost-effectiveness
Economic evaluation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
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Created: Sun, 13 Feb 2011, 00:05:56 EST