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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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| 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. |
| format | Article |
| id | doaj-art-95e607e8e0bb4087899165542bb04656 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| 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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