Economic impact of reducing treatment gaps in depression

Paul McCrone; Allan H Young; Roland Zahn; Jonas Eberhard; Danuta Wasserman; Paolo Brambilla; Judit Balazs; Jose Caldas-de-Almeida; Andrea Ulrichsen; Vladmir Carli; Ana Antunes; Giandomenico Schiena; Vinciane Quoidbach; Patrice Boyer; Rebecca Strawbridge

doi:10.1192/j.eurpsy.2023.2415

Economic impact of reducing treatment gaps in depression

Paul McCrone, Allan H Young, Roland Zahn, Jonas Eberhard, Danuta Wasserman, Paolo Brambilla, Judit Balazs, Jose Caldas-de-Almeida, Andrea Ulrichsen, Vladmir Carli, Ana Antunes, Giandomenico Schiena, Vinciane Quoidbach, Patrice Boyer, Rebecca Strawbridge

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

BACKGROUND: Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach.

METHODS: A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated.

RESULTS: The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden.

CONCLUSIONS: Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.

Original language	English
Article number	e57
Journal	European psychiatry : the journal of the Association of European Psychiatrists
Volume	66
Issue number	1
Early online date	13 Jun 2023
DOIs	https://doi.org/10.1192/j.eurpsy.2023.2415
Publication status	Published - 13 Jun 2023

Keywords

Humans
Depressive Disorder, Major/diagnosis
Depression
Europe
Health Care Costs
Italy
Cost-Benefit Analysis

UN SDGs

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

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McCrone, P., Young, A. H., Zahn, R., Eberhard, J., Wasserman, D., Brambilla, P., Balazs, J., Caldas-de-Almeida, J., Ulrichsen, A., Carli, V., Antunes, A., Schiena, G., Quoidbach, V., Boyer, P., & Strawbridge, R. (2023). Economic impact of reducing treatment gaps in depression. European psychiatry : the journal of the Association of European Psychiatrists, 66(1), Article e57. https://doi.org/10.1192/j.eurpsy.2023.2415

@article{e3128c3ed0f2483992d0afc87e8a0e78,

title = "Economic impact of reducing treatment gaps in depression",

abstract = "BACKGROUND: Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach.METHODS: A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated.RESULTS: The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden.CONCLUSIONS: Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.",

keywords = "Humans, Depressive Disorder, Major/diagnosis, Depression, Europe, Health Care Costs, Italy, Cost-Benefit Analysis",

author = "Paul McCrone and Young, {Allan H} and Roland Zahn and Jonas Eberhard and Danuta Wasserman and Paolo Brambilla and Judit Balazs and Jose Caldas-de-Almeida and Andrea Ulrichsen and Vladmir Carli and Ana Antunes and Giandomenico Schiena and Vinciane Quoidbach and Patrice Boyer and Rebecca Strawbridge",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association.",

year = "2023",

month = jun,

day = "13",

doi = "10.1192/j.eurpsy.2023.2415",

language = "English",

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McCrone, P, Young, AH , Zahn, R, Eberhard, J, Wasserman, D, Brambilla, P, Balazs, J, Caldas-de-Almeida, J, Ulrichsen, A, Carli, V, Antunes, A, Schiena, G, Quoidbach, V, Boyer, P & Strawbridge, R 2023, 'Economic impact of reducing treatment gaps in depression', European psychiatry : the journal of the Association of European Psychiatrists, vol. 66, no. 1, e57. https://doi.org/10.1192/j.eurpsy.2023.2415

TY - JOUR

T1 - Economic impact of reducing treatment gaps in depression

AU - McCrone, Paul

AU - Young, Allan H

AU - Zahn, Roland

AU - Eberhard, Jonas

AU - Wasserman, Danuta

AU - Brambilla, Paolo

AU - Balazs, Judit

AU - Caldas-de-Almeida, Jose

AU - Ulrichsen, Andrea

AU - Carli, Vladmir

AU - Antunes, Ana

AU - Schiena, Giandomenico

AU - Quoidbach, Vinciane

AU - Boyer, Patrice

AU - Strawbridge, Rebecca

PY - 2023/6/13

Y1 - 2023/6/13

N2 - BACKGROUND: Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach.METHODS: A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated.RESULTS: The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden.CONCLUSIONS: Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.

AB - BACKGROUND: Major depressive disorder (MDD) is highly prevalent across Europe. While evidence-based treatments exist, many people with MDD have their condition undetected and/or untreated. This study aimed to assess the cost-effectiveness of reducing treatment gaps using a modeling approach.METHODS: A decision-tree model covering a 27-month time horizon was used. This followed a care pathway where MDD could be detected or not, and where different forms of treatment could be provided. Expected costs pertaining to Germany, Hungary, Italy, Portugal, Sweden, and the UK were calculated and quality-adjusted life years (QALYs) were estimated. The incremental costs per QALY of reducing detection and treatment gaps were estimated.RESULTS: The expected costs with a detection gap of 69% and treatment gap of 50% were €1236 in Germany, €476 in Hungary, €1413 in Italy, €938 in Portugal, €2093 in Sweden, and €1496 in the UK. The incremental costs per QALY of reducing the detection gap to 50% ranged from €2429 in Hungary to €10,686 in Sweden. The figures for reducing the treatment gap to 25% ranged from €3146 in Hungary to €13,843 in Sweden.CONCLUSIONS: Reducing detection and treatment gaps, and maintaining current patterns of care, is likely to increase healthcare costs in the short term. However, outcomes are improved, and reducing these gaps to 50 and 25%, respectively, appears to be a cost-effective use of resources.

KW - Humans

KW - Depressive Disorder, Major/diagnosis

KW - Depression

KW - Europe

KW - Health Care Costs

KW - Italy

KW - Cost-Benefit Analysis

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U2 - 10.1192/j.eurpsy.2023.2415

DO - 10.1192/j.eurpsy.2023.2415

M3 - Article

C2 - 37309907

SN - 0924-9338

VL - 66

JO - European psychiatry : the journal of the Association of European Psychiatrists

JF - European psychiatry : the journal of the Association of European Psychiatrists

IS - 1

M1 - e57

ER -

Economic impact of reducing treatment gaps in depression

Abstract

Keywords

UN SDGs

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