Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care: 12-month economic evaluation of a pragmatic randomised controlled trial

Cost Effectiveness and Resource Allocation

Jeanette Westman¹  Frida Labori²  Mikael Svensson²  Christina Möller³  Dominique Hange⁴  Cecilia Björkelund⁴  Anna Holst⁴  Irene Svenningsson⁴  Eva-Lisa Petersson⁴ 

[1] Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute;Health Economics and Policy/School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg;Primary Health Care Head Office, Närhälsan, Region Västra Götaland;Primary Health Care/School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Allmänmedicin;

关键词: Depression;    Care manager;    Cost-effectiveness;    Primary care;    Sweden;    Collaborative care;   

DOI  :  10.1186/s12962-021-00304-5

来源: DOAJ

【 摘 要 】

Abstract Objectives To study the cost-effectiveness of a care manager organization for patients with mild to moderate depression in Swedish primary care in a 12-month perspective. Methods Cost-effectiveness analysis of the care manager organization compared to care as usual (CAU) in a pragmatic cluster randomised controlled trial including 192 individuals in the care manager group and 184 in the CAU group. Cost-effectiveness was assessed from a health care and societal perspectives. Costs were assessed in relation to two different health outcome measures: depression free days (DFDs) and quality adjusted life years (QALYs). Results At the 12-month follow-up, patients treated at the intervention Primary Care Centres (PCCs) with a care manager organization had larger health benefits than the group receiving usual care only at control PCCs. Mean QALY per patient was 0.73 (95% CI 0.7; 0.75) in the care manager group compared to 0.70 (95% CI 0.66; 0.73) in the CAU group. Mean DFDs was 203 (95% CI 178; 229) in the care manager group and 155 (95% CI 131; 179) in the CAU group. Further, from a societal perspective, care manager care was associated with a lower cost than care as usual, resulting in a dominant incremental cost-effectiveness ratio (ICER) for both QALYs and DFDs. From a health care perspective care manager care was related to a low cost per QALY (36,500 SEK / €3,379) and DFD (31 SEK/€3). Limitations A limitation is the fact that QALY data was impaired by insufficient EQ-5D data for some patients. Conclusions A care manager organization at the PCC to increase quality of care for patients with mild-moderate depression shows high health benefits, with no decay over time, and high cost-effectiveness both from a health care and a societal perspective. Trial registration details: The trial was registered in ClinicalTrials.com ( https://clinicaltrials.gov/ct2/show/NCT02378272 ) in 02/02/2015 with the registration number NCT02378272. The first patient was enrolled in 11/20/2014.

【 授权许可】

Unknown