Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder

Joran Lokkerbol; Ben Wijnen; Henricus G. Ruhe; Jan Spijker; Arshia Morad; Robert Schoevers; Marrit K. de Boer; Pim Cuijpers; Filip Smit

doi:10.1080/14737167.2021.1844566

Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder

Joran Lokkerbol
, Ben Wijnen^*
, Henricus G. Ruhe
, Jan Spijker
, Arshia Morad
, Robert Schoevers
, Marrit K. de Boer
, Pim Cuijpers
, Filip Smit

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background/objective: To describe the design of ‘DepMod,’ a health-economic Markov model for assessing cost-effectiveness and budget impact of user-defined preventive interventions and treatments in depressive disorders. Methods: DepMod has an epidemiological layer describing how a cohort of people can transition between health states (sub-threshold depression, first episode of mild, moderate or severe depression (partial) remission, recurrence, death). Superimposed on the epidemiological layer, DepMod has an intervention layer consisting of a reference scenario and alternative scenario comparing the effectiveness and cost-effectiveness of a user-defined package of preventive interventions and psychological and pharmacological treatments of depression. Results are presented in terms of quality-adjusted life years (QALYs) gained and healthcare expenditure. Costs and effects can be modeled over 5 years and are subjected to probabilistic sensitivity analysis. Results: DepMod was used to assess the cost-effectiveness of scaling up preventive interventions for treating people with subclinical depression, which showed that there is an 82% probability that scaling up prevention is cost-effective given a willingness-to-pay threshold of €20,000 per QALY. Conclusion: DepMod is a Markov model that assesses the cost-utility and budget impact of different healthcare packages aimed at preventing and treating depression and is freely available for academic purposes upon request at the authors.

Original language	English
Pages (from-to)	1031-1042
Number of pages	12
Journal	Expert Review of Pharmacoeconomics and Outcomes Research
Volume	21
Issue number	5
Early online date	23 Nov 2020
DOIs	https://doi.org/10.1080/14737167.2021.1844566
Publication status	Published - 2021

Bibliographical note

Funding Information:
Development of DepMod was financially supported by The Netherlands Organisation for Health Research and Development (ZonMW), grant 50-50110-96-634. An earlier version was supported by the Netherlands? Ministry of Health (VWS). Joran Lokkerbol was supported by The Netherlands Organisation for Health Research and Development (ZonMw) Mental Healthcare Fellowship, grant #636320003. We acknowledge dr. Talitha Feenstra, prof. dr. Claudi Bockting, and the taskforce for the development of the Dutch Multidisciplinary Guideline for Depression for constructive comments on early drafts of this manuscript.

Publisher Copyright:
© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Funding

Development of DepMod was financially supported by The Netherlands Organisation for Health Research and Development (ZonMW), grant 50-50110-96-634. An earlier version was supported by the Netherlands? Ministry of Health (VWS). Joran Lokkerbol was supported by The Netherlands Organisation for Health Research and Development (ZonMw) Mental Healthcare Fellowship, grant #636320003. We acknowledge dr. Talitha Feenstra, prof. dr. Claudi Bockting, and the taskforce for the development of the Dutch Multidisciplinary Guideline for Depression for constructive comments on early drafts of this manuscript.

Funders	Funder number
Netherlands’ Ministry of Health
ZonMw	50-50110-96-634
Ministerie van Volksgezondheid, Welzijn en Sport	636320003

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 17 Partnerships for the Goals

Keywords

budget impact
Cost-effectiveness
depression
health-economic modeling
major depressive disorder

Access to Document

10.1080/14737167.2021.1844566

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Cite this

Lokkerbol, J., Wijnen, B., Ruhe, H. G., Spijker, J., Morad, A., Schoevers, R., de Boer, M. K., Cuijpers, P., & Smit, F. (2021). Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder. Expert Review of Pharmacoeconomics and Outcomes Research, 21(5), 1031-1042. https://doi.org/10.1080/14737167.2021.1844566

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title = "Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder",

abstract = "Background/objective: To describe the design of {\textquoteleft}DepMod,{\textquoteright} a health-economic Markov model for assessing cost-effectiveness and budget impact of user-defined preventive interventions and treatments in depressive disorders. Methods: DepMod has an epidemiological layer describing how a cohort of people can transition between health states (sub-threshold depression, first episode of mild, moderate or severe depression (partial) remission, recurrence, death). Superimposed on the epidemiological layer, DepMod has an intervention layer consisting of a reference scenario and alternative scenario comparing the effectiveness and cost-effectiveness of a user-defined package of preventive interventions and psychological and pharmacological treatments of depression. Results are presented in terms of quality-adjusted life years (QALYs) gained and healthcare expenditure. Costs and effects can be modeled over 5 years and are subjected to probabilistic sensitivity analysis. Results: DepMod was used to assess the cost-effectiveness of scaling up preventive interventions for treating people with subclinical depression, which showed that there is an 82\% probability that scaling up prevention is cost-effective given a willingness-to-pay threshold of €20,000 per QALY. Conclusion: DepMod is a Markov model that assesses the cost-utility and budget impact of different healthcare packages aimed at preventing and treating depression and is freely available for academic purposes upon request at the authors.",

keywords = "budget impact, Cost-effectiveness, depression, health-economic modeling, major depressive disorder",

author = "Joran Lokkerbol and Ben Wijnen and Ruhe, \{Henricus G.\} and Jan Spijker and Arshia Morad and Robert Schoevers and \{de Boer\}, \{Marrit K.\} and Pim Cuijpers and Filip Smit",

note = "Funding Information: Development of DepMod was financially supported by The Netherlands Organisation for Health Research and Development (ZonMW), grant 50-50110-96-634. An earlier version was supported by the Netherlands? Ministry of Health (VWS). Joran Lokkerbol was supported by The Netherlands Organisation for Health Research and Development (ZonMw) Mental Healthcare Fellowship, grant \#636320003. We acknowledge dr. Talitha Feenstra, prof. dr. Claudi Bockting, and the taskforce for the development of the Dutch Multidisciplinary Guideline for Depression for constructive comments on early drafts of this manuscript. Publisher Copyright: {\textcopyright} 2020 The Author(s). Published by Informa UK Limited, trading as Taylor \& Francis Group.",

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Lokkerbol, J, Wijnen, B, Ruhe, HG, Spijker, J, Morad, A, Schoevers, R, de Boer, MK, Cuijpers, P & Smit, F 2021, 'Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder', Expert Review of Pharmacoeconomics and Outcomes Research, vol. 21, no. 5, pp. 1031-1042. https://doi.org/10.1080/14737167.2021.1844566

Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder. / Lokkerbol, Joran; Wijnen, Ben; Ruhe, Henricus G. et al.
In: Expert Review of Pharmacoeconomics and Outcomes Research, Vol. 21, No. 5, 2021, p. 1031-1042.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder

AU - Lokkerbol, Joran

AU - Wijnen, Ben

AU - Ruhe, Henricus G.

AU - Spijker, Jan

AU - Morad, Arshia

AU - Schoevers, Robert

AU - de Boer, Marrit K.

AU - Cuijpers, Pim

AU - Smit, Filip

N1 - Funding Information: Development of DepMod was financially supported by The Netherlands Organisation for Health Research and Development (ZonMW), grant 50-50110-96-634. An earlier version was supported by the Netherlands? Ministry of Health (VWS). Joran Lokkerbol was supported by The Netherlands Organisation for Health Research and Development (ZonMw) Mental Healthcare Fellowship, grant #636320003. We acknowledge dr. Talitha Feenstra, prof. dr. Claudi Bockting, and the taskforce for the development of the Dutch Multidisciplinary Guideline for Depression for constructive comments on early drafts of this manuscript. Publisher Copyright: © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2021

Y1 - 2021

N2 - Background/objective: To describe the design of ‘DepMod,’ a health-economic Markov model for assessing cost-effectiveness and budget impact of user-defined preventive interventions and treatments in depressive disorders. Methods: DepMod has an epidemiological layer describing how a cohort of people can transition between health states (sub-threshold depression, first episode of mild, moderate or severe depression (partial) remission, recurrence, death). Superimposed on the epidemiological layer, DepMod has an intervention layer consisting of a reference scenario and alternative scenario comparing the effectiveness and cost-effectiveness of a user-defined package of preventive interventions and psychological and pharmacological treatments of depression. Results are presented in terms of quality-adjusted life years (QALYs) gained and healthcare expenditure. Costs and effects can be modeled over 5 years and are subjected to probabilistic sensitivity analysis. Results: DepMod was used to assess the cost-effectiveness of scaling up preventive interventions for treating people with subclinical depression, which showed that there is an 82% probability that scaling up prevention is cost-effective given a willingness-to-pay threshold of €20,000 per QALY. Conclusion: DepMod is a Markov model that assesses the cost-utility and budget impact of different healthcare packages aimed at preventing and treating depression and is freely available for academic purposes upon request at the authors.

AB - Background/objective: To describe the design of ‘DepMod,’ a health-economic Markov model for assessing cost-effectiveness and budget impact of user-defined preventive interventions and treatments in depressive disorders. Methods: DepMod has an epidemiological layer describing how a cohort of people can transition between health states (sub-threshold depression, first episode of mild, moderate or severe depression (partial) remission, recurrence, death). Superimposed on the epidemiological layer, DepMod has an intervention layer consisting of a reference scenario and alternative scenario comparing the effectiveness and cost-effectiveness of a user-defined package of preventive interventions and psychological and pharmacological treatments of depression. Results are presented in terms of quality-adjusted life years (QALYs) gained and healthcare expenditure. Costs and effects can be modeled over 5 years and are subjected to probabilistic sensitivity analysis. Results: DepMod was used to assess the cost-effectiveness of scaling up preventive interventions for treating people with subclinical depression, which showed that there is an 82% probability that scaling up prevention is cost-effective given a willingness-to-pay threshold of €20,000 per QALY. Conclusion: DepMod is a Markov model that assesses the cost-utility and budget impact of different healthcare packages aimed at preventing and treating depression and is freely available for academic purposes upon request at the authors.

KW - budget impact

KW - Cost-effectiveness

KW - depression

KW - health-economic modeling

KW - major depressive disorder

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Design of a health-economic Markov model to assess cost-effectiveness and budget impact of the prevention and treatment of depressive disorder

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Persistent URL (handle)

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Cite this