Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).

<h4>Background</h4>Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking.<h4>Aims</h4>To assess the cost-effectiveness of collaborative care in a UK primary care setting.<h4>Methods</...

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Main Authors: Colin Green, David A Richards, Jacqueline J Hill, Linda Gask, Karina Lovell, Carolyn Chew-Graham, Peter Bower, John Cape, Stephen Pilling, Ricardo Araya, David Kessler, J Martin Bland, Simon Gilbody, Glyn Lewis, Chris Manning, Adwoa Hughes-Morley, Michael Barkham
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0104225
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author Colin Green
David A Richards
Jacqueline J Hill
Linda Gask
Karina Lovell
Carolyn Chew-Graham
Peter Bower
John Cape
Stephen Pilling
Ricardo Araya
David Kessler
J Martin Bland
Simon Gilbody
Glyn Lewis
Chris Manning
Adwoa Hughes-Morley
Michael Barkham
author_facet Colin Green
David A Richards
Jacqueline J Hill
Linda Gask
Karina Lovell
Carolyn Chew-Graham
Peter Bower
John Cape
Stephen Pilling
Ricardo Araya
David Kessler
J Martin Bland
Simon Gilbody
Glyn Lewis
Chris Manning
Adwoa Hughes-Morley
Michael Barkham
author_sort Colin Green
collection DOAJ
description <h4>Background</h4>Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking.<h4>Aims</h4>To assess the cost-effectiveness of collaborative care in a UK primary care setting.<h4>Methods</h4>An economic evaluation alongside a multi-centre cluster randomised controlled trial comparing collaborative care with usual primary care for adults with depression (n = 581). Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) were calculated over a 12-month follow-up, from the perspective of the UK National Health Service and Personal Social Services (i.e. Third Party Payer). Sensitivity analyses are reported, and uncertainty is presented using the cost-effectiveness acceptability curve (CEAC) and the cost-effectiveness plane.<h4>Results</h4>The collaborative care intervention had a mean cost of £272.50 per participant. Health and social care service use, excluding collaborative care, indicated a similar profile of resource use between collaborative care and usual care participants. Collaborative care offered a mean incremental gain of 0.02 (95% CI: -0.02, 0.06) quality-adjusted life-years over 12 months, at a mean incremental cost of £270.72 (95% CI: -202.98, 886.04), and resulted in an estimated mean cost per QALY of £14,248. Where costs associated with informal care are considered in sensitivity analyses collaborative care is expected to be less costly and more effective, thereby dominating treatment as usual.<h4>Conclusion</h4>Collaborative care offers health gains at a relatively low cost, and is cost-effective compared with usual care against a decision-maker willingness to pay threshold of £20,000 per QALY gained. Results here support the commissioning of collaborative care in a UK primary care setting.
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spelling doaj-art-95e607e8e0bb4087899165542bb046562025-08-20T03:46:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0198e10422510.1371/journal.pone.0104225Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).Colin GreenDavid A RichardsJacqueline J HillLinda GaskKarina LovellCarolyn Chew-GrahamPeter BowerJohn CapeStephen PillingRicardo ArayaDavid KesslerJ Martin BlandSimon GilbodyGlyn LewisChris ManningAdwoa Hughes-MorleyMichael Barkham<h4>Background</h4>Collaborative care is an effective treatment for the management of depression but evidence on its cost-effectiveness in the UK is lacking.<h4>Aims</h4>To assess the cost-effectiveness of collaborative care in a UK primary care setting.<h4>Methods</h4>An economic evaluation alongside a multi-centre cluster randomised controlled trial comparing collaborative care with usual primary care for adults with depression (n = 581). Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICER) were calculated over a 12-month follow-up, from the perspective of the UK National Health Service and Personal Social Services (i.e. Third Party Payer). Sensitivity analyses are reported, and uncertainty is presented using the cost-effectiveness acceptability curve (CEAC) and the cost-effectiveness plane.<h4>Results</h4>The collaborative care intervention had a mean cost of £272.50 per participant. Health and social care service use, excluding collaborative care, indicated a similar profile of resource use between collaborative care and usual care participants. Collaborative care offered a mean incremental gain of 0.02 (95% CI: -0.02, 0.06) quality-adjusted life-years over 12 months, at a mean incremental cost of £270.72 (95% CI: -202.98, 886.04), and resulted in an estimated mean cost per QALY of £14,248. Where costs associated with informal care are considered in sensitivity analyses collaborative care is expected to be less costly and more effective, thereby dominating treatment as usual.<h4>Conclusion</h4>Collaborative care offers health gains at a relatively low cost, and is cost-effective compared with usual care against a decision-maker willingness to pay threshold of £20,000 per QALY gained. Results here support the commissioning of collaborative care in a UK primary care setting.https://doi.org/10.1371/journal.pone.0104225
spellingShingle Colin Green
David A Richards
Jacqueline J Hill
Linda Gask
Karina Lovell
Carolyn Chew-Graham
Peter Bower
John Cape
Stephen Pilling
Ricardo Araya
David Kessler
J Martin Bland
Simon Gilbody
Glyn Lewis
Chris Manning
Adwoa Hughes-Morley
Michael Barkham
Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).
PLoS ONE
title Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).
title_full Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).
title_fullStr Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).
title_full_unstemmed Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).
title_short Cost-effectiveness of collaborative care for depression in UK primary care: economic evaluation of a randomised controlled trial (CADET).
title_sort cost effectiveness of collaborative care for depression in uk primary care economic evaluation of a randomised controlled trial cadet
url https://doi.org/10.1371/journal.pone.0104225
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