Cost-utility analysis of a collaborative care intervention for Major Depressive Disorder in an occupational healthcare setting

M. Goorden, M.C. Vlasveld, J.R. Anema, W. van Mechelen, A.T.F. Beekman, R. Hoedeman, C. van der Feltz-Cornelis, L. Hakkaart-van Roijen

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    Abstract

    Purpose Major depression is associated with high levels of absence and reduced productivity. Therefore the costs to society are high. The aim of this study was to evaluate the cost-utility of collaborative care for major depressive disorder (MDD) compared to care as usual in an occupational healthcare setting. A societal perspective was taken. Methods In this randomised controlled trial, 126 sick-listed workers with MDD were included (65 collaborative care, 61 care as usual). Baseline measurements and follow up measures (3, 6, 9 and 12 months) were assessed by questionnaire. We applied the Trimbos/iMTA questionnaire for costs associated with psychiatric illness, the SF-HQL and the EQ-5D respectively measuring the health care utilization, production losses and general health related quality of life. Results The average annual healthcare costs in the collaborative care group were €3,874 (95 % CI €2,778-€5,718) compared to €4,583 (95 % CI €3,108-€6,794) in the care as usual group. The average quality of life years (QALY's) gained were lower in the collaborative care group, 0.05 QALY. The majority of the ICERS (69 %) indicate that collaborative care is less costly but also less effective than care as usual. Including the productivity costs did not change this result. Conclusions The cost-utility analysis showed that collaborative care generated reduced costs and a reduction in effects compared to care as usual and was therefore not a cost-effective intervention. © 2013 Springer Science+Business Media New York.
    Original languageEnglish
    Pages (from-to)555-562
    JournalJournal of Occupational Rehabilitation
    Volume24
    Issue number3
    DOIs
    Publication statusPublished - 2014

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    Goorden, M., Vlasveld, M. C., Anema, J. R., van Mechelen, W., Beekman, A. T. F., Hoedeman, R., ... Hakkaart-van Roijen, L. (2014). Cost-utility analysis of a collaborative care intervention for Major Depressive Disorder in an occupational healthcare setting. Journal of Occupational Rehabilitation, 24(3), 555-562. https://doi.org/10.1007/s10926-013-9483-4